Staying strong

Accountability, re­form are hot top­ics at AHLA

Modern Healthcare - - The Week In Healthcare - Joe Carl­son

The long, slow slog out of the re­ces­sion that has damp­ened spend­ing in other sec­tors of the econ­omy didn’t hurt at­ten­dance at the 2011 Amer­i­can Health Lawyers As­so­ci­a­tion An­nual Meet­ing last week in Bos­ton, where at­tor­neys gath­ered for up­dates on the myr­iad new chal­lenges fac­ing health­care providers.

Es­ti­mated at­ten­dance at the three­day event reached 1,300 lawyers and ven­dors—about 50 shy of the all-time record, or­ga­niz­ers said.

AHLA CEO and Ex­ec­u­tive Vice Pres­i­dent Peter Lei­bold noted that al­though earn­ings at some law firms are down, over­all em­ploy­ment of health lawyers re­mains steady—and that’s no sur­prise, given the his­toric legal chal­lenges fac­ing health­care providers.

Reg­u­la­tors un­der Pres­i­dent Barack Obama have placed an enor­mous new em­pha­sis on en­force­ment in an­titrust and fraud. That in­cludes a re­cent will­ing­ness by the HHS’ in­spec­tor gen­eral’s of­fice to start us­ing its long-dor­mant power to se­lec­tively ex­clude health­care ex­ec­u­tives from Medi­care in cases where their com­pa­nies are snared in fraud al­le­ga­tions.

Greg Demske, as­sis­tant in­spec­tor gen­eral for legal af­fairs in HHS’ in­spec­tor gen­eral’s of­fice, said reg­u­la­tors are fac­ing tough ques­tions from leg­is­la­tors and the pub­lic about re­cidi­vist health­care firms that rack up mul­ti­ple fraud set­tle­ments with­out any seem­ing accountability for their be­hav­ior. “They are ask­ing, ‘How can a com­pany com­mit that kind of con­duct and no one can go to jail? In fact, no one can even lose their jobs?’ ” Demske said dur­ing a session that de­scribed the cur­rent reg­u­la­tory cli­mate as “The Age of Accountability.”

Fed­eral law says the gov­ern­ment doesn’t have to prove that health­care ex­ec­u­tives were aware of il­le­gal con­duct in or­der to ex­clude them from par­tic­i­pat­ing in Medi­care—a pun­ish­ment con­sid­ered “the death penalty” for a health­care ex­ec­u­tive’s ca­reer.

Demske said the rule was de­signed in part to foil the plau­si­ble-de­ni­a­bil­ity de­fenses ex­ec­u­tives use to in­su­late them­selves from fraud.

No gather­ing of health­care of­fi­cials would be com­plete with­out ex­ten­sive dis­cus­sion over the con­tin­u­ing battle from last year’s Pa­tient Pro­tec­tion and Affordable Care Act. Mas­sachusetts Gov. De­val Pa­trick gave one of three key­note ad­dresses on the ACA, declar­ing that the state’s ef­forts to ex­tend health in­surance cov­er­age to 98% of its res­i­dents had not cut the cost in the growth of health­care spend­ing be­low the in­creases seen around the rest of the coun­try.

Pa­trick said Mas­sachusetts-style health­care re­form can work on a na­tional level if the ACA is given a chance to suc­ceed. What’s wor­ri­some, he said, is not the “me­chan­ics” of the bill but rather the tone of the po­lit­i­cal rhetoric that sur­rounds it, which he said de­volves into ar­gu­ments over big or lit­tle gov­ern­ment with­out par­tic­i­pants look­ing at the more mean­ing­ful ques­tions. “Get over it—let’s move on and talk about what we’re try­ing to do and whether that is worth it,” he said. “To say that we can (re­form the health­care sys­tem) state by state, one-off, is an ab­di­ca­tion of the fact that we are one nation.”

Those com­ments came only min­utes af­ter Vir­ginia At­tor­ney Gen­eral Ken­neth Cuc­cinelli, a staunch op­po­nent of the ACA, gave a key­note speech in which he said in re­sponse to an au­di­ence ques­tion that the proper way to re­quire all Amer­i­cans to buy in­surance would be to amend the Con­sti­tu­tion to give Congress the power to do that. Ab­sent that, the power to com­pel in­surance-buy­ing is re­served for states such as Mas­sachusetts, which has done just that. “I don’t nec­es­sar­ily like what Mas­sachusetts has done, but I’m per­fectly happy they’ve done it,” Cuc­cinelli said.

For more cov­er­age of the AHLA meet­ing, go to mod­ern­health­­tion/liveat-ahla.

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