Greg Fliszar and Christopher Raphaely will be presenting at the Pennsylvania Bar Institute's Health Law Institute.
Greg will be presenting "Hot Reimbursement Issues from the Perspective of Providers and Health Plans." This topic will address the current landscape of the hottest and newest legal issues in health care reimbursement in terms of reimbursement controversies, disputes and how to avoid them. The presentation will be given from the unique perspective of lawyers representing both the provider and health plan sides of the issues.
Chris will be presenting "Hospital Price Transparency - Compliance and Business Implications." Shifting the $1 trillion dollar hospital industry from confidential payer contracts to publicly published pricing is a massive transformation. New CMS hospital price transparency requirement implicate public relations and business strategy issues, yielding a wide range of hospital and health system approaches to reporting the required data. As compliance increases, we are entering a world of publicly visible payer contracts which affect everything from negotiation strategies to value-based care. We will review: the specific regulatory requirements to report hospital pricing data, the risk of partial compliance, CMS penalties and the implication of pricing transparency on confidentiality clauses in payer contracts; a sample of Philadelphia area pricing data; and what this change means for payer negotiations, value based care, pricing strategy and other business issues.