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Practice Group Update
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Please visit our blog for information on upcoming events, including the Orlando Health Care Forum scheduled for Spring 2016. More details to follow. |
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Broad and Cassel South Florida Attorneys Named Top Lawyers
| South Florida Legal Guide has named 17 Broad and Cassel attorneys to its 2016 Top Lawyers list. Additionally, Senior Counsel Heather Miller was named a 2016 Top Up and Comer. Peers nominated the attorneys, including all four South Florida managing partners, for inclusion on the list. The firm also was named a 2016 Top Law Firm.
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Health Care Fraud Attorney Joins Broad and Cassel
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We are pleased to announce the addition of health care fraud and abuse attorney Benton Curtis. He joins the Miami office as senior counsel in the firm's nationally recognized Health Law Practice Group.
Please visit this page to learn more about Curtis' background and practice.
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Contributors
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Mike Segal
Partner
View Bio
Michael Bittman
Partner
View Bio
Paul DeMuro
Of Counsel
View Bio
Stephen Siegel
Of Counsel
View Bio
Heather Miller
Senior Counsel
View Bio
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To our clients and friends:
Well, 2015 is in the books. It was quite a ride for the health care sector. Let's review quickly a few of the more major developments that occurred:
First, reimbursement continued to move towards taking risk. The types of risk ranged from pay for performance to bundled payments, partial risk, full risk and much more focused on fixed prices (subject to meeting quality metrics) for a certain patient population. In November CMS mandated, with respect to hip and knee surgeries, bundled payments for hospitals in 67 different geographic areas (including urban Florida areas) beginning April 2016, with the payments being subject to downside risk beginning in 2017. Further, 21 Next Generation full risk ACOs were accepted by CMS beginning this year.
This new bundled payment initiative was one result of the passage in April of the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA authorizes changes to Medicare reimbursement for physicians and others to incentivize them to move away from fee for service and towards alternative payment models that utilize the "triple aim," i.e., better care at a lower cost for a defined patient population.
Private equity continued to invest in the health care industry. In the physician sector its interest spread beyond the traditional hospital based providers, to areas like primary care and dermatology.
The U.S Department of Justice finished its busy year in enforcement by announcing that in 2015 it had recovered $3.5 billion in settlements and judgments under the Federal False Claims Act against healthcare providers and suppliers.
All of what I have discussed, along with a myriad of other health care reimbursement trends, are likely to continue unabated during 2016. If we want to remain in the health care arena we have no choice but to adapt.
HAPPY NEW YEAR!
Sincerely,
Mike Segal
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Veteran Health Law Attorney Joins Broad and Cassel
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We are pleased to announce that Mark Folk has joined the firm's nationally recognized Health Law Practice Group as a partner. During his more than 25-year career, Folk has focused his practice on working with health care systems to manage risks associated with integrating physicians and new lines of business into established patient-care models. He joins the firm from Waller Lansden Dortch & Davis, LLP, in Nashville, Tenn.
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Demystifying Data Analytics for General Counsel
| By: Paul DeMuro
One cannot go anywhere these days and not hear about data analytics and big data. These concepts are becoming increasingly relevant in health care. We see applications in banking (electronic banking) and the use of customer data for a variety of purposes. In addition, the travel industry (consumer websites that will find your hotel or airline reservation and Uber), consumer products (Amazon), and Sports all use data analytics in some way. Health care has been one of the industries that has been slow to adapt information technology and data analytics.
Please continue reading this article on page 4 of The Advisory Board Company's December 2015 "General Counsel Agenda."
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6 ways health care providers can reduce fraud, waste and abuse risks in 2016
| By: Michael Bittman
Health care providers such as hospitals and doctors face a variety of legal risks: malpractice, tax, and fraud, waste and abuse.
Recent cases have shown that fraud, waste and abuse exposure can dwarf the risk of malpractice and tax liability. Providers participating in federal health care programs (Medicare, Medicaid, TRICARE) are obligated to assess their fraud, waste and abuse risks and take steps to minimize those risks. Failure to do so exposes them to severe criminal, civil and administrative penalties, and reputational harm.
Please visit the Orlando Business Journal to continue reading.
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In 2016 Expect More Changes
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By: Stephen Siegel
Last year was a challenging one for healthcare providers. The challenges in 2015 included: the final implementation of ICD-10; two multi-million dollar Civil False Claims settlements involving physician-hospital relationships in Florida; elimination of the annual battle over the sustainable growth rate; final regulations for Stage 3 Meaningful Use, and the apparent end of Florida's cap on non-economic damages. This year, 2016, promises to bring new challenges. Here are four of the issues that likely will be the focus of many physicians and other healthcare providers' attention:
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