The Light at the End of the Tunnel . . . or Cliff0

 This article was published on June 5, 2014, in Corporate Compliance Insights.

iStock_000000261863Small“Truth emerges more readily from error than from confusion.”  — Francis Bacon

With each passing day health care reform in America gains momentum, even as the chasm between successful and unsuccessful providers continues to expand. Earlier this month, the Federal Government tested the fortitude of the system when it released thousands of regulatory pages explaining the many ways in which Medicare providers will get paid and penalized over the next few years.  Eagerly awaited by those in the field, the 2015 Hospital Inpatient Prospective Payment System regulations for acute care hospitals lives up to all expectations as it journeys through the labyrinth created by such diffuse entities as the Hospital Value-Based Purchasing Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Conditions Reduction Program.  Not to disappoint its devoted readers, the Powers That Be issued regulations the same week for skilled nursing facilities, inpatient psychiatric facilities, inpatient rehabilitation facilities, hospices, and federally qualified health centers. … Read more →

Administrative, Clinical, Community, Health Care Law, Health Care Reform, Historical, Hospitals, Miscellaneous, News, Regulatory

Lessons Learned from Dial-Up0

This article was first published in the Daily Journal on May 15, 2014.

iStock_000013044243MediumIn the largest cities across the U.S., locating an Internet connection has become as easy as finding a cup of coffee. In modern times, however, the ability to effectively communicate in business is inextricably connected to the rate by which one is able to transfer data. Like a bad cup of coffee, we may tolerate a slow connection when options are limited, but no one really enjoys it. Lessons from both support the notion that we not only prefer quality speed, but it also improves our performance at work.

If bit rates are the standard measurement for telecommunications, hospital beds present the equivalent in health care. … Read more →

Administrative, Community, Health Care Law, Health Care Reform, Historical, Hospitals, Lost Hospital, Miscellaneous, News, Non Clinical, Regulatory, Technology

What Are We Fighting to Reform?0

This article was first published in California Healthcare News on May 6, 2014.

IMG_2220“Revelation can be more perilous than Revolution.”  — Vladimir Nabokov

As in baseball, the history of war favors the home team, especially when the home team prevails.  Not surprisingly, those who come in second place on the battlefield have little say in the telling of the tale. What became of the Ottoman and Austria-Hungarian Empires receives anecdotal attention, though those who live in Istanbul, Vienna and Budapest remember the Great War much like the City of Buffalo remembers Scott Norwood. So, too, will the success or failure of America’s struggle to provide universal health care be decided in the grand scheme, with little thought given to the smaller scale of unfortunate losses incurred upon the way. … Read more →

Administrative, Clinical, Community, Health Care Law, Health Care Reform, Historical, Hospitals, Lost Hospital, News, Regulatory

Another Healthcare Crisis: Closing Hospitals0

This Op-ed appeared in the Los Angeles Times on February 26, 2014.

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Lower Oconee Community Hospital in southern Georgia closed its doors this month, eliminating 25 hospital beds and up to 100 hospital jobs. This was the fourth Georgia hospital to fold in two years and the eighth rural hospital in the state to close since 2000. Although Lower Oconee’s shutdown may not have registered much media coverage, those in search of medical attention in Glenwood, Ga., should be mindful that the closest hospital is now 30 miles away. As reference, Santa Ana  is 30 miles from Los Angeles. When faced with a medical emergency, no one fancies a long road trip. … Read more →

Administrative, Community, Health Care Law, Health Care Reform, Historical, Hospitals, Lost Hospital, News, Non Clinical, Regulatory

American Health Care’s Temporal Order0

(January 26, 2014) The world of contemporary health care is not based upon absolutes, but rather an ever-evolving system of beliefs influenced at any given time by a confluence of advances in science, popular culture, current events and religion.  As these and other components shape that which we as a nation accept as truth, some historical notions transition away from their previously influential roles in society, to be replaced by ideologies that better conform to modern standards.  Given enough time and perspective, these erstwhile canons can even transcend into the realm of mythology and folklore. As with the idea that the mentally ill were once widely believed to be victims of demonic possession, what was once considered an immutable medical truth is now viewed as a quaint theory of an immature age.

Historically, the science of medicine presents a wealth of examples to show how fleeting truth can be, even within the context of life and death. … Read more →

Administrative, Clinical, Community, Health Care Law, Historical, Hospitals, News, Non Clinical, Regulatory, Technology

The Beginning of Health Care Reform Nears Its End0

This article was first published in the Los Angeles Daily Journal on December 16, 2013.

iStock_000023873789Small“Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.” — Sir Winston Leonard Spencer Churchill

The countdown to 2014 has begun. In the days to come, millions of Americans will choreograph exactly where to be at midnight on New Year’s Eve, full of resolutions and expectations for the coming year. This January 1 holds a special significance for our country, as the dropping of that massive 11,875-pound ball in New York City’s Times Square represents what many have for four years hoped to be the heralding of an epic transformation in our nation’s health care. Though unable to predict the future as in fairy tales of old, the descent of that Waterford crystal ball marks the coming of age of the Affordable Care Act (ACA), still shrouded in controversy and fighting for a foothold on which to support itself. … Read more →

Administrative, Children's Health, Clinical, Community, Health Care Law, Health Care Reform, Historical, Hospitals, News, Non Clinical, Regulatory, Technology

The Struggle to Find a Home in the Affordable Care Act and a Place in History0

This article first appeared in the Pharmaceutical Compliance Monitor on October 14, 2013.
iStock_000000954565Medium“The more sand that has escaped from the hourglass of our life, the clearer we should see through it.”  –Jean-Paul Sartre

When discussing the prospect of change to the structure of the American health care system, a little background is in order. Historically, the pharmaceutical industry has yielded to certain cyclical patterns that emerge when a new drug or treatment is introduced to the marketplace or new regulations come into effect, resulting in an initial surge followed in time by greater restraints imposed from both the federal and state level. Since its inception in 2010, the Affordable Care Act has in many ways preempted these cycles as it seeks to provide a nearly universal health care blanket by constructing a new foundation made of regulatory building blocks aimed at shifting emphasis from a cost based to a performance driven philosophy that it believes will reduce fraud and waste, thereby lowering costs across the board.  Within its folds exist a number of pharmaceutical specific studies and programs designed to more accurately police the industry as the federal government attempts to curtail spending. With the emergence of the ACA, today’s pharmaceutical companies find themselves in an all too familiar situation, overlooking a vast new horizon of potentiality while beset by a host of new rules, where the prospect of greater market opportunity grapples with the restrictions that accompany increased regulation. … Read more →

Administrative, Clinical, Community, Health Care Law, Health Care Reform, Historical, Hospitals, News, Non Clinical, Pharmacy, Regulatory

PBS’s ‘This Emotional Life’: Eye on the Elderly: Helping Seniors in the Hospital Setting

This article was previously published on the Huffington Post.

“All diseases run into one, old age.”
–Ralph Waldo Emerson

Finding oneself in the hospital can be trying at any age. But for the elderly such an experience comes with a host of separate issues, both mental and physical, that need to be addressed in conjunction with prompt and professional care for their ailment. As our nation’s baby boomers begin to retire and medical advances increase life span, the average patient age continues to rise, a trend that appears to have no end in sight. In our efforts to assist an aging friend, relative or loved one, it is important to keep in mind that patience and perspective rule the day.

In this fast-paced modern age, when a young or middle-aged person gets sidelined through illness or accident, his or her thoughts often refer to the quotidian: school or work responsibilities, upcoming social events and family obligations. While the elderly entertain these thoughts as well, in many instances their priorities and focus will differ considerably. What may seem trivial to a 25-year-old may be of great importance to a patient of 85, be it paying the phone bill, watering the plants or feeding the cat. As a result, one of the most helpful things we can do when visiting sick, elderly patients is to ask them what they feel needs to be done. Through the simple act of listening, the caregiver or friend offers the understanding that the patient is not alone, and the needs of their life outside the hospital are being met. This frees them to focus their attention on the illness at hand and offsets the feelings of loneliness and helplessness that come with any hospital stay. … Read more →

Administrative, Clinical, Community, Health Care Law, Health Care Reform, Historical, Hospitals, Miscellaneous, News, PBS This Emotional Life

Proceed With Caution: Matters to Consider for Business Lawyers Transitioning into Health Care0

This article first appeared in the NY Business Law Journal in November 2012.

When venturing into areas of law outside their usual practice, attorneys should be mindful of state-specific standards to which they are held.  Rule 3-110 of the California Rules of Professional Conduct sets the standard on the west coast, just as Rule 1.1 of the New York Rules of Professional Conduct applies on the east.  Absent the requisite skill to accommodate a client’s needs, an attorney may still engage and adhere to the statutory definition of competence by “associating with or, where appropriate, professionally consulting another lawyer reasonably believed to be competent” or “by acquiring sufficient learning and skill before performance is required.”[1]  In 2003, a California Appellate Court explained:  “Attorneys are expected ‘to possess knowledge of those plain and elementary principles of law which are commonly known by well informed attorneys, and to discover those additional rules of law which, although not commonly known, may readily be found by standard research techniques.’”[2]

However, due to the sheer volume and complexity of information generated regularly in the wake of reform, modern health care law exists in a league of its own. … Read more →

Administrative, Clinical, Community, Health Care Law, Health Care Reform, Historical, Hospitals, Miscellaneous, News, Regulatory

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