Health Care Reform, Transition and Transformation in Long Term Care

Friday, March 28, 2014 -
8:30am to 4:00pm

In this year’s annual symposium national experts, scholars and practitioners will examine how the Affordable Care Act is transforming financing, coordination and delivery of care, quality evaluation, and protection from waste , fraud and abuse in the long term care industry.

This event is free and open to the public however, registration is required.

6.2 Missouri CLE credits will be available.

For more information please contact Cheryl Cooper at 314.977.3067 or ccoope22@slu.edu

Speakers

 

John T. Boese

Of Counsel, Fried, Frank, Harris, Shriver & Jacobson LLP


John Boese is a national expert on the civil False Claims Act and qui tam actions. He became of counsel at Fried, Frank, Harris, Shriver & Jacobsen LLP after being partner of the firm for 30 years. Boese has represented a number of clients including hospitals, physician practice groups, insurance companies, pharmaceutical companies, universities, import/export firms and a variety of other entities. His practice has led him to appear in more than 40 federal district courts as well as many of the federal circuit courts of appeal. Boese is also the author of the book “Civil False Claims and Qui Tam Actions” (Wolters, Kluwer Law Business, 4th ed.), which is a two-volume treatise discussing administration of the Civil False Claims Act and qui tam actions at the state and federal levels. His treatise has been cited as the authority on the subject by courts at every level including the U.S. Supreme Court. In 2008, Boese also testified before the Senate Judiciary Committee concerning proposed amendments to the False Claims Act. He is co-chair of the annual ABA National Institute on the Civil False Claims Act and is vice-chair of the Debarment and Suspension Committee of the Section on Public Contract Law. He also served as co-chair of the Qui Tam Subcommittee of the ABA Section of Criminal Justice from 1998-2006. Boese received his undergraduate degree from Washington University and his J.D. from Saint Louis University School of Law, where he served as an editor of the Saint Louis University Law Journal.


Judith Feder

Professor of Public Policy
McCourt School of Public Policy, Georgetown University


Judy Feder is a professor of public policy and, from 1999 to 2008, served as dean of what is now the McCourt School of Public Policy at Georgetown University. A nationally-recognized leader in health policy, Feder has made her mark on the nation’s health insurance system, through both scholarship and public service. A widely published scholar, her health policy research began at the Brookings Institution, continued at the Urban Institute, and, since 1984, flourished at Georgetown University. In the late 1980s, she moved from policy research to policy leadership, actively promoting effective health reform as staff director of the congressional Pepper Commission (chaired by Sen. John D. Rockefeller IV) in 1989-90; principal deputy assistant secretary for planning and evaluation at the Department of Health and Human Services in President Bill Clinton’s first term; a senior fellow at the Center for American Progress (2008-2011) and, today, as an Institute Fellow at the Urban Institute. Feder is a political scientist, with a B.A. from Brandeis University, and a master's and Ph.D. from Harvard University.


Mark A. Frey

President and Chief Executive Officer, Alexian Brothers Health System


Mark Frey was named president and CEO of the Alexian Brothers Health System on Dec. 1, 2011. A 27-year Alexian Brothers employee, Frey previously served as president and CEO of Alexian Brothers Behavioral Health Hospital, CEO of the Alexian Brothers Rehabilitation Hospital, and vice president of the Alexian Neurosciences Institute. He was the driving force behind the behavioral health hospital's growth and rise to prominence. Under Frey's leadership the health system also pioneered cross-disciplinary alliances with neurologists and neurosurgeons to provide innovative treatments for Alzheimer's disease, Parkinson's disease and other movement disorders.

As the first layperson ever to be appointed to lead the health system, Frey played a key role in Alexian Brothers decision to seek a partnership with Ascension Health, the nation's largest Catholic and non- profit health system, whose resources have helped the Alexian Brothers Health System’s health care and housing ministries continue to serve the communities that depend on them. He completed his undergraduate degree at the University of Illinois at Chicago, his master’s of Social Work at Loyola University of Chicago, and his Juris Doctor at the Illinois Institute of Technology/Chicago-Kent College of Law, and has held a number of administrative and teaching positions.


David C. Grabowski

Professor of Health Care Policy
Department of Health Care Policy
Harvard Medical School


David C. Grabowski is a professor of health care policy in the Department of Health Care Policy at Harvard Medical School. His research focuses on the economics of aging with a particular interest in the area of long-term care. His research has considered issues related to long-term care financing, organization and delivery of services. Grabowski is the principal investigator on ongoing grants from the National Institute on Aging examining Medicare payment incentives and the implications for nursing home volume, patient acuity and quality of care; selection and the impact of ownership on nursing home quality; and, public policy and the demand for long-term care insurance. Other ongoing projects include an examination of the economic incentives associated with hospitalizations from the nursing home setting, work analyzing the relationship between Medicare and Medicaid in long-term care, and an analysis of the growth in potential substitutes for nursing home care, such as assisted living. Grabowski is also leading a team at Harvard in the evaluation of the CMS Nursing Home Value-Based Purchasing Demonstration. Grabowski is a co-editor of the journal Health Services and Outcomes Research Methodology and he is a member of the editorial board of Medical Care Research & Review and B.E. Journals in Economic Analysis & Policy. He was the 2004 recipient of the Thompson Prize for Young Investigators from the Association of University Programs in Health Administration. Grabowski received his BA from Duke University and his Ph.D. in public policy from the Irving B. Harris School of Public Policy at the University of Chicago


Malcolm J. Harkins, III

Partner, Proskauer Rose LLP


Malcolm J. Harkins, III is a partner in the health care department at Proskauer. After founding and practicing law for almost 15 years with the nationally-known health care firm of Casson & Harkins, Harkins joined Proskauer in 1992. He represents numerous institutional health care providers, including hospitals, nursing homes and pharmacies, as well as several state and national associations of health care providers. Harkins also represents individuals and companies involved in managed care, home health care, congregate living facilities, therapy services and durable medical equipment. Finally, he represents a number of states on matters involving federal funding of the states’ Medicaid programs and with respect to a variety of other matters involving the states’ relationships with the federal government.

He serves as an adjunct professor at SLU LAW’s Center for Health Law Studies, as well as in the Department of Health Policy in the School of Public Health and Health Services and in the Department of Health Services Management and Leadership of The George Washington University.

Harkins has written and published numerous articles on a broad range of topics of interest to the health care industry, including, among others, managing and surviving the inspection process, securing appropriate payment, structuring health care joint ventures in compliance with federal and state laws, restructuring the health care company to succeed after health care reform and providing, documenting and defending quality of care. He often has been asked to speak to state and national professional societies and associations and to others involved in the health care field, including, among others, the American Health Lawyers Association, the American Academy of Hospital Attorneys, the American Medical Directors Association, the United States Department of Justice Nursing Home Abuse and Neglect Regional Conferences, the American Bar Association and the National Association of Medicaid Fraud Control Units and the Association of American Law Schools.


Marshall B. Kapp

Director, Center for Innovative Collaboration in Medicine & Law and Professor of Medicine and Law, Florida State University College of Law


Marshall B. Kapp is the director of the Florida State University Center for Innovative Collaboration in Medicine and Law, with faculty appointments as professor in the Department of Geriatrics at FSU College of Medicine, and professor of medicine and law in the FSU College of Law. He also is affiliated with the FSU Pepper Institute on Aging and Public Policy. Kapp is editor emeritus of the Journal of Legal Medicine, a fellow of the Gerontological Society of America and the American College of Legal Medicine, and a recipient of GSA’s Kent Award. He received his B.A. from Johns Hopkins University, J.D. from George Washington University Law School and an M.P.H. from Harvard University School of Public Health.


Andy Mao

Assistant Director, Elder Justice Initiative Coordinator
Civil Division, Fraud Section
U.S. Department of Justice


Andy Mao is the coordinator of the U.S. Department of Justice’s Elder Justice and Nursing Home Initiative. He is also an assistant director in the Commercial Litigation Branch of the Justice Department’s Civil Division. Mao focuses on health care fraud matters and has litigated matters in the hospital, pharmaceutical, and nursing home contexts. He also advises the Department and coordinates efforts with other federal agencies regarding elder justice issues. He joined the Department in 2000 after completing his clerkship in the District of New Jersey. Mao is a graduate of Cornell University and the University of Virginia School of Law.


Lisa Re

Chief of the Administrative and Civil Remedies Branch in the Office of Counsel to the Inspector General, U.S. Department of Health and Human Services


Lisa Re is the Chief of the Administrative and Civil Remedies Branch in the Office of Counsel to the Inspector General, U.S. Department of Health and Human Services. This office, working with the Department of Justice, participates in every health care fraud case brought under the False Claims Act; negotiates and monitors Corporate Integrity Agreements; pursues monetary and exclusion cases under the Civil Monetary Penalties Law; and defends exclusion actions. Lisa is a graduate of Saint Louis University School of Law and Saint Louis University School of Nursing. Prior to attending law school, Lisa worked as a critical care registered nurse.


Carol H. Steckel

Senior Director of Public Policy, WellCare


Carol H. Steckel serves as the senior director of Public Policy at Wellcare in Tampa, Fla. Steckel previously was director of the Division of Medical Assistance for the North Carolina Department of Health and Human Services. Prior to that post, she served as Louisiana’s Medicaid director from 2003-2010 and was the director of the Center for Health Care Innovation at the Louisiana Department of Health and Hospitals.


Michael D. Thamer

Law Offices of Michael D. Thamer


Michael D. Thamer is a nationally-recognized trial attorney who has tried more 40 jury trials in state and federal courts, two of which were the largest verdicts in the nation at the time: Lavender v. Skilled Healthcare Group, Inc. and In re Conservatorship of Gregory. In 2010, Thamer, as lead trial lawyer in the historic Lavender v. Skilled Healthcare class action lawsuit, obtained for 32,000 plaintiff class members a jury verdict in excess of $670 million dollars after a seven month trial, as well as injunctions against Skilled Healthcare and its 23 subsidiary corporations requiring compliance with California’s minimum staffing laws at 22 skilled nursing facilities. Lavender is the largest verdict in the nation against a provider of skilled nursing services to the elderly. And as sole trial counsel, Thamer obtained a jury verdict, including $94 million dollar punitive damage award, in an elder abuse action involving a single plaintiff against Beverly Enterprises, Inc. [(2000) 80 Cal.App.4th 514.] Thamer’s civil and criminal trial work has been featured on “60 Minutes,” “CBS Evening News,” and in numerous print media, including Time Magazine, Wall Street Journal, Los Angeles Times, San Francisco Chronicle, Sacramento Bee, San Jose Mercury News, California Lawyer, California Law Business Journal, and Outside Magazine. Thamer has a degree in Social Ecology from University of California, Irvine and is also a graduate of Santa Clara University School of Law.

Schedule

TimeSession

8:30am-9:00am

REGISTRATION


9:00am-9:10am

WELCOME

Michael A. Wolff
Dean, Professor of Law
Saint Louis University School of Law

OPENING REMARKS

Thomas (Tim) Greaney
Chester A Myers Professor of Law
Co-Director, Center for Health Law Studies,
Saint Louis University School of Law


9:10am-10:15am

SESSION ONE – The Financing of Long Term Care

The Challenge of Financing Long Term Care
Judith Feder
Professor of Public Policy
McCourt School of Public Policy, Georgetown University

Care Coordination for Dually Eligible Beneficiaries
David C. Grabowski
Professor of Health Care Policy
Department of Health Care Policy
Harvard Medical School


10:15am-10:25am

BREAK


10:25am-11:55am

SESSION TWO -- The Transformation of LTC in the Healthcare System​

Home and Community-Based Long Term Care Services and Supports: What Does Health Reform Have to Do With It?
Marshall B. Kapp
Director, Center for Innovative Collaboration in Medicine & Law
Professor of Medicine and Law
Florida State University College of Law

Positioning LTSS in the National Health Care System
Mark Frey
President and Chief Executive Officer
Alexian Brothers Health System

Long Term Care and Managed Care: Completing the Continuum of Care
Carol H. Steckel
Senior Director of Public Policy
WellCare


11:55am-1:00pm

LUNCH


1:00pm-2:05pm

SESSION THREE -- Regulation v. Litigation to Ensure Quality

The Nursing Home Survey: The Broken Promise of OBRA '87
Malcolm J. Harkins, III
Partner
Proskauer Rose LLP

Skilled Nursing: Why Private Enforcement is Necessary
Michael D. Thamer
Law Offices of Michael D. Thamer


2:05pm – 2:20pm

BREAK


2:20pm – 3:50pm

SESSION FOUR -- Waste, Fraud and Abuse

OIG’s Oversight of Nursing Homes
Lisa Re
Branch Chief, Administrative and Civil Remedies Branch
Office of Counsel to the Inspector General
U.S. Department of Health and Human Services

Department of Justice Efforts in the Long Term Care Arena
Andy Mao
Assistant Director, Elder Justice Initiative Coordinator
Civil Division, Fraud Section
U.S. Department of Justice

Upcoding Mistakes to Fraud: Recent Developments in Theories of Liability and Defense of False Claims Act Allegations Against Healthcare Providers
John T. Boese
Fried Frank Harris Shriver & Jacobson LLP


3:50pm

CONCLUSION


 

The Financing of Long Term Care

The Transformation of Long Term Care in the Health Care System

Regulation V Litagation to Ensure Quality

Waste, Fraud, and Abuse

Address

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