Accountability, reform are hot topics at AHLA
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 modernhealthcare.com/section/liveat-ahla.