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 →

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 →

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 →

Regulatory Compliance Has No Speed Traps0

This article was first published on Corporate Compliance Insights on February 26, 2014.

iStock_000000906033Medium“A truth that’s told with bad intent / Beats all the lies you can invent.”  — William Blake

Formed through legislation signed by President Gerald Ford in 1976, the Office of the Inspector General (“OIG”) is one federal agency that should never be underestimated by those in the health care industry. In its pursuit to protect the integrity of health care programs and the welfare of their beneficiaries, the OIG boasts the power to determine the fate of most health care providers through standards both objective (42 U.S.C. § 1320a-7(a) – Mandatory Exclusions) and subjective (42 U.S.C. § 1320a-7(b) – Permissive Exclusions). While those unfortunate enough to find themselves on the List of Excluded Individuals and Entities (LEIE) may at times disagree, the pellucidity with which the OIG enforces its statutory directive is in perfect alignment with the transparency through which the agency insists providers conduct their business. … Read more →

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 →

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_000023873789SmallNow 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 →

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_000000954565MediumThe 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 →

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 →

The Familiar Path of Health Care Reform0

This article first appeared in the Daily Journal on August 5, 2013.

iStock_000023873789Small copyFriedrich Nietzsche wrote: “When we are tired, we are attacked by ideas we conquered long ago.”

More than three years deep into the Affordable Care Act, 13 months since the U.S. Supreme Court confirmed its constitutionality, and almost 10 months after the American public approved reform through the Electoral College, modern American health care is now poised to shine or make its claim as a historical disaster. As the nation prepares for the health insurance exchange, the next few months shall prove critical in determining the trajectory — and thus the fate — of our health care system, and we would be remiss not to notice the storm clouds forming overhead. … Read more →