Payers, Providers, and Patients – Oh My!

In this episode, Joe Records and Payal Nanavati talk to Scott Douglas and Charlotte Freed about the mental health provisions in the federal gun safety legislation. The new law included billions in federal funds to support mental health care—a huge investment likely to have major impacts on the industry.

Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

This episode is the second part in a miniseries with Crowell Health Solutions, which is a strategic consulting firm that Crowell & Moring launched earlier this year to help healthcare organizations and technology companies transform health care by improving patient care and health outcomes, advancing health equity, and lowering health care costs through solutions like digital health innovations and value-based healthcare models.

In this episode, Janet Walker and Roma Sharma interview three leaders working at Ascension, which is one of the nation’s largest not-for-profit health systems with more than 2,600 sites of care, about how Ascension has prioritized health equity and population health initiatives, including its framework “ABIDE,” which is built upon the hallmarks of Appreciation – Belongingness – Inclusivity – Diversity – Equity.  The interviewees are Dr. Stacy Garrett-Ray (Senior Vice-President and Chief Community Impact Officer), Pamela Mitchell Boyd (Senior Director of ABIDE), and Nicole Commodore (Director, Community Impact and Advocacy).

 

Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

 

For more information, please see:

• Crowell & Moring Unveils Crowell Health Solutions

In this episode, host Joe Records talks to Gary Baldwin about the regulation of shared-risk arrangements in the state of California. They discuss the history of shared-risk arrangements in California, how the Department of Managed Health Care (DMHC) approaches these kinds of arrangements, and the kinds of issues entities should consider in approaching shared risk.

 

Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

This episode is the first part in a miniseries with Crowell Health Solutions, which is a strategic consulting firm that Crowell & Moring launched earlier this year to help healthcare organizations and technology companies transform health care by improving patient care and health outcomes, advancing health equity, and lowering health care costs through solutions like digital health innovations and value-based healthcare models.

In this episode, Troy Barsky interviews Michael Meng (the CEO of Stellar Health) about how technology has impacted, and continues to impact, health care delivery in light of regulatory changes focused on advancing value-based care.  Michael Meng is the CEO and co-founder of Stellar Health, which is a healthcare technology company focused on enabling success across the value-based care continuum by bridging the incentive gap between providers and payors.

Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

For more information, please see:

• Crowell & Moring Unveils Crowell Health Solutions
• Stellar Health

In this episode, hosts Payal Nanavati and Joe Records talk to Katy Raffensperger, Todd Rosenberg, and Alexis Gilman about expectations for healthcare transactions in 2022.   The discussion captures how transactions involving health care companies may respond to legal, economic, and market circumstances, including lasting care delivery changes spurred by the COVID pandemic, antitrust scrutiny by federal regulators, inflation, and rising interest rates.

 

Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

In this episode, hosts Payal Nanavati and Joe Records talk to Matt Vicinanzo about developments in False Claims Act litigation – including materiality, scienter, and government dismissal authority, among others – and how those developments may have a unique impact on companies in the health care industry.

For more information please see:

• "The Top FCA Developments of 2021," Government Contracts Bullet Points (February 25, 2022). Contacts: Brian Tully McLaughlin, Lyndsay A. Gorton, Nkechi Kanu, Payal Nanavati, Matthew Vicinanzo.
• "Payers, Providers, and Patients – Oh My!: FCA Dismissals Under the Granston Memo," Podcast: Payers, Providers, and Patients – Oh My! (June 26, 2019). Contacts: John T. Brennan Jr., Joe Records, Payal Nanavati.
• "Payers, Providers, and Patients – Oh My!: Data Analytics and FCA Investigations," Health Care Alert (January 21, 2021). Contacts: Michael Shaheen, Joe Records, Payal Nanavati.

Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

In this episode, hosts Payal Nanavati and Joe Records talk to Troy Barsky and Roma Sharma about their reflections on the first year of implementation of new regulations implementing the major fraud and abuse statutes — the Stark Law and Anti-Kickback Statute (AKS) — including discussing challenges, opportunities, and outstanding questions about the new exceptions and safe harbors for value-based care.

 

For more information please see:

• "CMS Issues Sweeping Reform to Modernize the Stark Law: Part I," Health Care Alert (November 30, 2020). Contacts: Troy A. Barsky, John T. Brennan Jr., Lidia Niecko-Najjum, Roma Sharma.
• "OIG Issues Final Rule to Update AKS Safe Harbors: Part II," Administrative Law Alert (February 25, 2021). Contacts: Troy A. Barsky, Jodi G. Daniel, Michael Shaheen, Lidia Niecko-Najjum, Joe Records, Matthew Vicinanzo.

 

Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

In this episode, hosts Payal Nanavati and Joe Records talk to Jodi Daniel and Savanna Williams about the latest developments in interoperability, including challenges of implementing recent CMS and ONC regulations and expectations about potential enforcement of these rules. 

For more information please see:

• "HHS Finalizes Sweeping Regulations on Interoperability of Health Information and Information Blocking" 
• "Balancing The New Interoperability Rules With Existing Privacy Laws: Challenges for Payers" 
• "CMS Expands on Patient Access and Interoperability Requirements for Health Plans" 

Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

In this episode, hosts Payal Nanavati and Joe Records talk to Janet Walker and Mercy Care’s CEO, Lorry Bottrill about the ways in which the government and health plans are addressing the social determinants of health (SDOH), which are the conditions in which people are born, live, learn, work, play and age and they affect a wide range of health, functioning, and quality-of-life outcomes. 

 

Lorry has been a leader in Arizona’s health care community for more than 25 years.  In this episode, she shares recent examples of Mercy Care’s efforts to address SDOH through collaboration with the Arizona Health Care Cost Containment System (AHCCCS or “ACCESS”), Arizona’s Medicaid agency. 

 

For more information please see:

• Mercy Care
• CDC Notice of Funding Opportunity: Closing the Gap with Social Determinants of Health Accelerator Plans
• CMS Innovation Center Strategy Refresh
• AHCCCS Whole Person Care Initiative

 

Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

You can follow Lorry Bottrill here.

In this episode, hosts Payal Nanavati and Joe Records talk to Lidia Niecko-Najjum and John Brennan about the legal issues that investors, providers, and innovators should be prepared to navigate when considering offering Ketamine-assisted treatment, including the federal and state laws and regulations related to the practice of medicine, licensure, and many other issues. 

Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.