ABA Health eSource April 2012 Volume 8 Number 8
ABA Health eSource - Your link to the ABA's Health Law Section
April 2012 Volume 8 Number 8
Health Law Section NewsApril 11, 2012
April 12, 2012
Emerging Issues in Health Information Exchanges
(CLE Webinar & Teleconference)
April 19, 2012
Healthcare Antitrust Fundamentals
(CLE Webinar & Teleconference)
April 26, 2012
The Crime of Doing Nothing: New Threats for Corporate Officers
(CLE Webinar & Teleconference)

Health Law Highlights

Health Law News

ACO Resources & News

HHS Office of Inspector General (OIG)

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Chair's Column:
Think! (or the Whiteness of the Whale)

By David H. Johnson, Bannerman & Johnson, P.A., Albuquerque, NM

So what do Aretha Franklin, Herman Melville and a Nobel laureate in economics have in common? Read on, shipmates, read on.

I have long believed that a critical skill in the practice of law is the ability to understand the context of my clients’ problems. For me, this skill was largely learned during the years I spent working as a nurse practitioner. I was educated in the old school by clinicians who believed that the most important element of clinical decision-making was the patient history.

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This edition of eSource is brought to you by the Healthcare Fraud & Compliance Interest Group.

New Bipartisan Legislation Poised to Enhance Regulatory Regime for Children’s Clinical Studies
By Steven W. Postal, JD, Manager, Oncology Research, Washington Cancer Institute at MedStar Washington Hospital Center

On March 28, 2012, Representatives Anna Eshoo (D-CA), Edward Markey (D-MA) and Mike Rodgers (R-MI) introduced the BPCA and PREA Reauthorization Act of 2012 (H.R. 4274) (“The 2012 Bill”), which has been referred to the House Energy and Commerce Committee. If the 2012 Bill does not pass, BPCA (Best Pharmaceuticals for Children Act) and PREA (Pediatric Research Equity Act) will sunset on October 1, 2012, five years after their last reauthorization. The 2012 Bill would make both Acts permanent. The American Academy of Pediatrics (“AAP”), the Elizabeth Glaser Pediatric AIDS Foundation (“EGPAF”), the Pharmaceutical Research and Manufacturers of America (“PhRMA”), and the Biotechnology Industry Organization (“BIO”) have already issued public statements of support, with the latter two expressly supporting permanent reauthorization.

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HITECH Task Force Re-Convenes to Address "Megarule"
By John R. Christiansen, Christiansen IT Law, Seattle, WA

Since the final HITECH “megarule” has been submitted to the Office of Management and Budget ("OMB") for final pre-publication review, with a possible publication date in mid-to-late June 2012, the Health Law Section's eHealth, Privacy & Security Interest Group is re-convening the HITECH Task Force to identify volunteers with the time and willingness to help deliver articles, sample forms, podcasts and webinars covering various aspects of the new rules.

Many members have already contributed to development of some of these deliverables, and we have some draft materials which will need to be updated and finalized.

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Predictive Modeling: The New Frontier in Medicare Claims Review
By Cybil G. Roehrenbeck, American Medical Association, Washington, DC

Section 4241 of the Small Business Jobs Act of 2010 authorizes the Secretary of the Department of Health and Human Services ("HHS") to use predictive modeling and other analytics technologies to identify improper claims for reimbursement and to prevent the payment of such claims under the Medicare fee-for-service program. The statute provides that the predictive modeling program should capture Medicare provider and beneficiary activities across the Medicare program to provide a comprehensive view of all providers, beneficiaries, and geographies within the program. The goal is to identify and analyze provider networks, provider billing patterns, and beneficiary utilization patterns, and to use that information to detect patterns and networks that represent a high risk of fraudulent activity.

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HEAT Actions Since the Beginning of FY2012
by Matthew Fisher, Mirick O’Connell, Worcester, MA

Since the beginning of Fiscal Year 2012, the Medicare Fraud Strike Forces (the “MFSF”) operating within the Health Care Fraud Prevention and Enforcement Action Team (“HEAT”) have been very active, making numerous arrests, obtaining new indictments, securing plea bargains, and obtaining verdicts. HEAT is active across the country, with a significant portion of its recent enforcement activity occurring in Florida, Illinois, Louisiana, Michigan, New York, and Texas.

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National Healthcare Decisions Day Set for April 16

Join Americans across the country in making their future healthcare decisions known to family, friends, and healthcare providers. Share your wishes and complete your advance directive, because…YOUR DECISIONS MATTER.  Learn more about National Healthcare Decisions Day and get free information at www.nhdd.org.

Did you know membership in an interest group is FREE with your Health Law Section membership?

Did you know your membership in the ABA Health Law Section qualifies you for free membership in up to three interest groups of your choice? Interest groups, which are comprised of twelve practices areas within health law, make significant contributions to the Section's programming, publications and legislative initiatives. The interest groups also provide an excellent opportunity for you to interact with and have access to some of the most outstanding lawyers in the legal community. You can enroll on our webpage by clicking here. If you have any questions or need more information, please contact Simeon Carson at simeon.carson@americanbar.org

Healthcare Fraud & Compliance Interest Group

The Healthcare Fraud & Compliance Interest Group addresses topical, cutting edge issues which are the focus of fraud and abuse prevention, investigations and prosecutions, including but not limited to compliance issues, emerging managed care issues, kickback and Stark Law issues, institutional and non-institutional and physician issues, ethical issues, false claims issues, quality of care issues, and private sector as well as private sector enforcement initiatives.

The IG is led by Chair Gwen Kathleen Chapman, Arthrocare, Inc., Austin , TX and Vice Chairs Joel M. Androphy, Berg & Androphy, Houston, TX; John Steiner, Cancer Treatment Centers of America, Schaumburg, IL; Martha Talley, OIG, Dept of Health & Human Services, Chevy Chase, MD and Winifred M. Weitsen, Venable LLP, Washington, DC.

If you would like to join the Interest Group, continue by clicking the following link: Health Law Section IG Sign-up Form.

ABA eSource Editorial Board

The ABA Health eSource Editorial Board is led by Editor, Marla Durben Hirsch, Chair Adrienne Dresevic, The Health Law Partners, PC, Southfield, MI and editorial board members Claire Castles, Jones Day, Los Angeles, CA; Michael E. Clark, Duane Morris LLP, Houston, TX; Potomac, MD; Conrad Meyer, Chaffe McCall, LLP, New Orleans, LA; Robert T. Rhoad, Crowell & Moring LLP, Washington, DC and Jennifer Tsao, Hernandez Schaedel & Associates LLP, Pasadena, CA.

Do you want to communicate your ideas to thousands of other members? To contribute a newsletter article on a health law topic, send us your ideas to simeon.carson@americanbar.org.
The opinions expressed are those of the authors and shall not be construed to represent the policies or positions of the ABA or the ABA Health Law Section.
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