Strategies to Deal With the Patient Protection & Affordable Care Act
The Patient Protection and Affordable Care Act as amended (PPACA) has been the subject of significant legal and policy debate since it was enacted in March 2010. The legislation has been both hailed as an important victory in the battle to improve the quality and accessibility of healthcare in the United States and challenged as unconstitutional and ineffective in reducing medical costs. Amidst this debate, legal and business strategies for dealing with the aspects of Health Care Reform that have been, or soon will be, implemented are often left in the background.
These strategies are critical for ensuring compliance and optimizing business performance as PPACA rolls out. No matter how the broader policy or legal debate resolves, entities affected by PPACA must consider the Act’s impact on reimbursement, cost protection, and other day-to-day operational issues.
Strategies to Deal With the Patient Protection and Affordable Care Act LIVE Webcast is a must-attend event for healthcare professionals, health policy directors, health executives, pharmaceutical and medical device manufacturers and others who are interested in developing practical strategies to deal with healthcare reform. The Knowledge Group has assembled a panel of key thought leaders and regulators to discuss the fundamentals and updates regarding this topic.
Robert Bradner, Partner,
Holland & Knight LLP
- Understanding the overall scope and breadth of the PPACA with respect to expanding health coverage
- Understanding the concept and mechanics of the American Health Benefits Exchange
- Understanding the scope of the Medicaid Coverage Expansion
- Issues that will impact the success or failure of the coverage expansions
Elizabeth P. Papez, Partner (former Deputy Assistant Attorney General in the U.S. Justice Department’s Office of Legal Counsel),
Winston & Strawn LLP
- Impact of PPACA on civil liability exposure for healthcare providers, suppliers, and manufacturers
- Intersection between PPACA provisions and provider and supplier program exclusion and criminal (including Anti-Kickback and Park) prosecutions
- Compliance and risk-mitigation strategies for doing business, directly or indirectly, with Medicare and Medicaid under the new law
JBrian G. Flood, Managing Director,
- The Patient Protection and Affordable Care Act, Public Law 111-148 (Act), creates new potent requirements for providers and suppliers to return Medicare and Medicaid overpayments. Subsection 6402(d)(1) of the Act says:
- If a person has received an overpayment, the person shall—
- Report and return the overpayment to the Secretary [of the U.S. Department of Health & Human Services], the State, an intermediary, a carrier, or a contractor, as appropriate, at the correct address; and
- Notify the Secretary, State, intermediary, carrier, or contractor to whom the overpayment was returned in writing of the reason for the overpayment.
- In Subsection 6402(d)(2), the Act goes on to set the deadline to return the overpayment:
- An overpayment must be reported and returned under paragraph (1) by the later of —
- The date which is 60 days after the date on which the overpayment was identified; or
- The date any corresponding cost report is due, if applicable.
Michael Thompson, Principal, Global Human Resources Solutions Group,
- Survey results on current state of health benefits and impact of health reform
- Strategic considerations of health reform for employers
- Go forward strategies to bend the cost curve.
- Health and reward strategies for 2012 and beyond
Susan M. Nash, Partner,
McDermott Will & Emery
- Immediate market reforms under PPACA (i.e. grandfathering, lifetime and annual limits; external review of benefit appeals; coverage of adult dependent children and state taxation issues) and employer responses;
- W-2 Reporting and Health Flexible Spending Account Changes
- Pay or Play Mandates and How Employers are Responding
- Update on Wellness Programs
Who Should Attend:
- Health Services Professionals
- Health Industry Advisors
- Health Care Law Attorneys
- Senior Corporate Management
- Health Care Advisory Services Consultants
- Health Policy Directors
- State Health Executives/Professionals
Robert H. Bradner is a Partner in the Washington, D.C. office of Holland & Knight. Prior to joining the firm, Mr. Bradner spent 13 years in government service, including 7 as Chief of Staff and Counsel to Congressman John Edward Porter of Illinois, Chairman of the House Appropriations Subcommittee on Labor, Health and Human Services, Education and related agencies, and Senior Member of the Subcommittee on Foreign Operations, Export Financing and Related Programs. He also practiced in intergovernmental and environmental law in Holland & Knight’s Chicago office.
Mr. Bradner is experienced on the federal budget and appropriations process and he has broad experience in the legislative and regulatory arena. He provides counseling, strategy development, drafting and advocacy services on even the most complex and difficult matters of federal policy. He is particularly knowledgeable on legal and policy issues in the areas of health, education, employment, environment and international affairs.
Mr. Bradner possesses over a decade of experience successfully impacting the development of policy by the Department of Health and Human Services in such areas as Medicare and Medicaid reimbursement, the regulation of healthcare providers, and biomedical research and development. He has a similar record of involvement in the development of employment and labor policies. His work with the education community has included assisting academic medical centers and research universities to address research resource issues and to obtain regulatory relief, helping institutions of higher education to address workforce, liability and funding needs and advocating on elementary and secondary education issues.
Robert H. Bradner is a Partner in the Washington, D.C. office of Holland & Knight. Prior to joining the firm, …
Elizabeth Papez is a litigation partner and member of the firm’s nationwide appellate and critical motions practice. Ms. Papez has extensive private and public sector experience litigating high-profile matters and counseling clients on the legal and strategic aspects of complex business and compliance issues.
Elizabeth Papez is a litigation partner and member of the firm’s nationwide appellate and critical motions practice. Ms. Papez has …
Professional and Industry Experience
Mr. Flood joined KPMG’s Forensic Practice as Managing Director in August, 2007 with more than 15 years experience in the industry. Prior to joining KPMG, he was the Inspector General for the Health and Human Services Commission, recruited and appointed by the Texas Governor, and served 2003-2007. In his previous position he annually oversaw 58 billion dollars in total assets, 17 billion in claims, thousands of beneficiaries, audits and investigations with an IG staff of over 500 that recovered or cost avoided approximately 3 billion dollars over a 4 year period. Prior to that position he was a criminal prosecutor, Division Chief and national instructor in trial and evidence issues.
In his role at KPMG he has assisted health care systems, providers, payers , PBMs, pharma and life science companies and private insurance carriers with health care reform, regulatory and compliance issues.
Brian is a regular speaker for the firm on healthcare compliance and enforcement activities. He also works with and advises local, state and federal government agencies on operational efficiency, regulatory compliance, risk mitigation strategies, integrity and enforcement issues.
Brian is on the board of directors for the Health Care Compliance Association; HCCA, the General Counsel Forum and past member of the board of directors for the Inspector General Association and the White Collar Crime Center.
Brian is an attorney and a certified Inspector General who carries the CHC, AHFI and CFS certifications as well.
Professional and Industry Experience Mr. Flood joined KPMG’s Forensic Practice as Managing Director in August, 2007 with more than 15 …
Michael Thompson is a Principal at PricewaterhouseCoopers with over 30 years of experience in healthcare and employee benefits strategy development and implementation, design, financing, operations and analysis. Mike consults with major employers, payers and other stakeholders on sustainable cost reduction, integrated health, wellness and consumerism, retiree health, and health reform.
Mike serves as one of PwC’s national thought leaders for health strategies for the health industries practice, and has participated on the steering board of the World Economic Forum “Working towards Wellness” initiative. For the past decade, he has been a leader in developing and promoting collaborative cross-sector health industry initiatives.
Mike is a Fellow of the Society of Actuaries (SOA) and serves on the Health Practice Council, Disease Management Committee, Medicare Committee of the American Academy of Actuaries (AAA). He also chairs the AAA Quality Initiatives Work Group which has release issue briefs on pay-for performance, comparative effectiveness, value-based insurance design and accountable care organizations. Mike also serves on the boards of the New York chapter of the National Alliance on Mental Illness and the New York Business Group on Health.
Mike is a primary author of multiple articles and publications including: “Employer Driven Consumerism – Integrating Health into the Business Model” (Employee Benefits Quarterly), “The Factors Fueling Rising Healthcare Costs” (AHIP Publication), “Healthcare Transformation, Leadership and the Evolution of Consumerism” (WELCOA), “The Healthcare Balancing Act: Aligning Objectives, Intentions and Incentives” (View), “Rethinking Our Approach to Containing Healthcare Costs” (Benefits & Compensation Solutions), “A New Equilibrium in Health and Rewards Strategy – Prospering in a Post-Health Care Reform World” (Benefits Quarterly).
Prior to joining PwC, Mike served as a health plan executive in both national and regional leadership roles related to underwriting, marketing, operations, government programs and product development, including CFO of the western region and national head of underwriting and contracts.
Michael Thompson is a Principal at PricewaterhouseCoopers with over 30 years of experience in healthcare and employee benefits strategy development …
Susan M. Nash is a partner in the law firm of McDermott Will & Emery LLP and is based in the Firm’s Chicago office. Susan focuses her practice primarily on the area of health and welfare benefit plans, including compliance with COBRA, HIPAA, ERISA, other federal laws affecting group health plans and the Internal Revenue Code.
She has represented a wide variety of clients in negotiations with the Internal Revenue Service, the Department of Labor, the Department of Health and Human Services and in contracting with HMOs and third-party vendors for welfare plans. She also has extensive experience working with employers, vendors and health plans to design and implement a variety of health and welfare plans, with a focus on medical, prescription drug, dental, disability, mental health benefits, cafeteria plans; and consumer-directed health plans, such as health reimbursement arrangements and health savings accounts.
Susan is chair of the McDermott Will & Emery Welfare Benefit Plan practice and a member of the Firm’s Consumer Directed Health Care practice. Susan is also a member of McDermott’s HIPAA task force and has counseled a wide variety of group health plans on compliance with HIPAA’s privacy, security, portability and nondiscrimination requirements.
Susan was recognized by Chambers USA as a leader in employee benefits and compensation law.
Susan M. Nash is a partner in the law firm of McDermott Will & Emery LLP and is based in …
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About Holland & Knight LLP
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About KPMG LLPKPMG LLP
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About McDermott Will & Emery
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Our Firm has over 75 years of experience serving a broad range of client interests.We understand the issues faced by corporate decision makers because many of our lawyers have held key government and in-house positions. We understand how economic, social and political issues affect operations because our lawyers have navigated the complex business and regulatory environment themselves.