Payers, Providers, and Patients – Oh My!

Digital Health Innovation

In this episode, hosts Payal Nanavati and Joe Records sit down with Jodi Daniel and Ambassador Robert Holleyman to discuss how regulators—across the U.S. and the rest of the world—can overcome the challenges of regulating emerging digital health technologies without stifling innovation. 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.

Materials Discussed in this Episode

• "The Future of Health is Digital: A Policy Roadmap," PDF, C&M International

Multi-State Plan Program

In this episode, hosts Payal Nanavati and Joe Records sit down with former regulators Jon Foley, Rob Shriver, and Kristi Martin to discuss the goals and design of the Affordable Care Act’s MSP Program—and what can be learned from its ultimate failure. Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

Materials Discussed in this Episode

• "For Policy Makers Looking To Expand Coverage, Lessons From The Demise Of The ACA’s Multi-State Plan Program," Health Affairs Blog, September 30, 2019

Pharmacy Benefit Managers

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 discuss PBMs with Todd Rosenberg.

Payers, Providers, and Patients – Oh My!: FDA Digital Health Guidance

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly 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 discuss recent FDA guidance related to digital health with Jodi Daniel and Shaina Vinayek.

Related Materials

• "FDA Seeks Comment on Clinical Decision Support Software Guidance and Issues Policy Updates on its Oversight Authority Regarding Medical Software and Apps," C&M Health Law, October 23, 2019

Medicare Advantage Supplemental Benefits

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this "deep dive" episode, hosts Payal Nanavati and Joe Records talk to Barbara Ryland about benefits under Medicare Part C.

Removal under ERISA

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this "deep dive" episode, hosts Payal Nanavati and Joe Records talk to Shelley Rosenberg about how health care defendants can use ERISA preemption as a way to remove litigation to federal court.

Some Potential Impacts of Legal Challenges to the ACA

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly 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 with Troy Barsky and Alice Hall-Partyka about how recent litigation challenging the constitutionality of the Affordable Care Act may impact providers and payers. The discussion focuses on the authority for innovative health care models and important fraud and abuse provisions that were enacted in the ACA.

Health Care Compliance Programs

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this episode, hosts Joe Records and Payal Nanavati talk with Jacinta Alves about compliance programs and how the government looks at them.

Private Equity Investing in Health Care

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this episode, hosts Joe Records and Payal Nanavati talk with Lex Eley and Stephanie Willis about what private equity firms need to consider when investing in health care.

Fiduciary Duties Under ERISA

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this episode, hosts Joe Records and Payal Nanavati talk with David McFarlane and Sam Krause about fiduciary duties related to health care under ERISA.

Materials Discussed in this Episode:

• ERISA at Crowell & Moring
• $28 Trillion and Personal Liability: ERISA Roars Back
• Court Unravels New Association Health Plan Rules
• ERISA Health Plan Compliance [PDF]
• ERISA Mental Health Parity Compliance [PDF]
• Fiduciary Protection - Employee Benefit Plans [PDF]