An interdisciplinary health care reform task force
The federal government has set in motion a period of revolutionary change in healthcare delivery and payment. With one of the broadest and deepest health care practices in the nation, and an intimate knowledge of all facets of the health care reform laws, King & Spalding will be providing cutting edge advice and a broad array of supportive legal services. Recognizing that the legal challenges clients face will be interrelated, complex, and necessitate depth of business acumen and vision, we have formed an interdisciplinary health care reform task force of over 40 lawyers and other professionals with expertise in the key legal issues affecting health care providers, manufacturers, pharmacies, investment banks, and employers of all types. Our task force professionals include nationally recognized leaders on matters related to employee benefit plan counseling and implementation, compliance, pricing, public policy, strategic counseling, coverage, payment, transactions, financing, antitrust, contracting, government relations, fraud and abuse, investigations, and other disciplines. Some of our senior lawyers were involved in the policy debate underlying the new law and already are actively involved in educating other lawyers and in counseling clients with respect to the law’s implementation. We are responding to our clients’ needs to understand the complexities of the new law to make strategic adjustments to their business models, so that they can mitigate risk, seize opportunities and flourish in this dramatically changing environment.
The largest health care industry practice in America
King & Spalding is a full-service firm with over 200 professionals who spent over one-half of their professional time on healthcare industry matters in 2009. According to Modern Healthcare, the firm maintains the largest health care industry practice in America, with 229 members of the American Health Lawyers Association. We have policy and business experts who have helped design and influence the development of significant health care laws, including the recently enacted health care reform laws, the Medicare Modernization Act, the Deficit Reduction Act, and several foundational laws governing payment and fraud and abuse. Our professionals have successfully helped clients navigate through the implementation challenges of new regulatory regimes and worked with clients to facilitate compliance with the nation’s fraud and abuse laws.
Mitigating risk, controlling costs, and managing the administrative burdens of change
Employers in all industries weigh the costs and benefits of providing healthcare benefits for their employees. Health care reform will impact a wide range of employee benefit issues, ranging from the design and implementation of health insurance and medical account plans to executive employment arrangements. There will be significant opportunities to mitigate risk, control costs, and manage the administrative burdens of change.
Our healthcare reform task force includes a number of professionals from our Employee Benefits and Executive Compensation practice who will assist with the legal and strategic challenges employers will face as the new system for health benefits emerges. Drawing on the expertise of other disciplines represented in the task force, including our leading healthcare industry professionals, our employee benefits lawyers will assist clients in responding to the incentives created by the reform law and regulations; achieving their optimal balance of benefits for employees and net employer costs; navigating mandated benefits, document compliance and employee communications; meeting reporting and disclosure requirements; enhancing cost containment strategies; and coordinating complex new requirements with other laws and corporate policies.
Our task force members who work with healthcare industry clients will collaborate actively with our employee benefits professionals in assessing the ways in which reform will affect the marketplace for healthcare services and insurance. They will bring their active involvement in physician and hospital services integration over the last 20 years, and more recent experiences supporting health information technology adoption, to assist healthcare providers of all types in preparing for payment reforms such as bundled pricing, medical homes and accountable care arrangements. Our top ranked Medicare/Medicaid reimbursement practitioners on the task force will help clients navigate upcoming reimbursement shifts and new reimbursement methodologies. Compliance specialists on the task force will assist clients with new compliance requirements and enforcement stringency that are also part of the reform process. Our professionals who focus on work for healthcare manufacturers will assist with assessments of marketplace changes, new taxes, price reporting changes, and physician payment reporting requirements.
As the Department of Labor (DOL), Department of Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS), the states, and other government entities publish hundreds of regulations and guidance documents in 2010, 2011, and beyond, to implement the new laws, task force members will engage government officials on a frequent and ongoing basis to advocate for appropriate interpretation and implementation of the new laws. Health care reform creates winners and losers – our task force will help clients know where they stand in advance so that they can solve problems, execute plans, and reduce downside exposure.
Our task force coordinates closely as a team and “connects the dots” between the various legal issues under health care reform that need multiple perspectives – including antitrust, tax, insurance regulatory and other areas. Each issue presented will benefit from a 360 degree perspective by task force specialists in all of the relevant legal disciplines.
For assistance in specific areas, members of the working groups within the healthcare reform task force are listed at the links below:
- Health Care Public Policy/Strategic Implementation
- Delivery System and Reimbursement Reforms
- Compliance and Enforcement Improvements
- Health Information Technology Adoption
- Health Insurance Market Reforms
- Health Manufacturer Focused Issues
- Specialty Provider, Pharmacy, Supplier Focused Issues
- Sub-Acute, Home Health, Long Term Care Focused Issues
Events and Publications:
Our task force members have provided industry leadership through the following healthcare reform educational events and publications:
- “The New Healthcare Delivery System: What are Accountable Care Organizations and Medical Homes?”, American Health Lawyers Association publication (Kim Roeder, author)
- “Structuring Quality and Productivity Incentives for Physicians, Now and for the Future,” session at the American Health Lawyers’ Association Hospitals and Health Systems conference, (February 2010. Kim Roeder, speaker)
- King & Spalding Healthcare Reform Roundtable, National Healthcare Reform Legislation: What it Says and How it will Change the Healthcare Industry (July 7, 2009. Jason McKitrick, Kim Roeder, Glen Reed, Dennis Barry, Jim Boswell, Stephanie Webster, Mark Smith)
- King & Spalding Healthcare Reform Roundtable, Part I – Implications for Employers, Insurance Availability, Provider Managed Care Contracting and Charity Care (April 16, 2010. Glen Reed, Donna Burchfield, Robert Keenan and James Boswell)
- King & Spalding Healthcare Reform Roundtable, Part II – Medicare, Medicaid and Delivery System Reform (April 23, 2010. Dennis Barry, Christopher Keough, Kim Roeder and Stephanie Webster)
- King & Spalding Healthcare Reform Roundtable, Part III – Enhanced Fraud & Abuse Liability and Compliance Challenges (May 7, 2010. Gary Eiland, Richard Shackelford, Stephanie Webster, Adam Robison)
- King & Spalding Healthcare Reform Roundtable, Part IV – Reform Driven Strategies and Tactics & State Options and Responsibilities (May 21, 2010. Tom Hawk, Kim Roeder, Christopher Keough, Mark Kelly and Glen Reed)
- Healthcare Reform: The Law and its Implications, American Health Lawyers’ Association Conference, Washington, D.C. (May 11-12, 2010. Glen Reed, conference co-chair and panelist, Dennis Barry, speaker and panelist)
- Healthcare Reform and How It Affects You (October 14, 2010. Kenneth Raskin, Mark Kelly and Laura Westfall)