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Regulation, Accreditation, and Payment

 
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Welcome to the Regulation, Accreditation, and Payment Practice Group (RAP PG). We keep you informed on the most up to date and relevant issues related to reimbursement and coverage, including Medicare and other government payer laws, regulations, and instructions, as well as issues related to health care organizational accreditation such as the Joint Commission and other accrediting entity standards.

Here are the top five things you can do to make the most of your membership in the RAP PG:

  1.  Register for a webinar or listen to an archived webinar: Web-based seminars address the recent decisions, new laws and regulations, and other substantive matters that are unique to the health care industry and clients.  Click here to access a list of upcoming and past webinars sponsored by the RAP PG.
  2. Join the Reimbursement Community: Discussion includes issues related to reimbursement and coverage. To join the Community, visit your "myAHLA" profile at www.healthlawyers.org/myahla, enter your login information, click the blue button to customize your "Email and List Preferences," and click "Save."
  3.  Sign up for an Affinity Group: Available at no additional fee, Affinity Groups facilitate networking and provide educational opportunities for members who share similar professional interests. If you did not select an Affinity Group when you joined AHLA, you can still do so. Simply complete and return this enrollment form or call AHLA's Member Service Center at (202) 833-1100, prompt #2. RAP PG members can enroll in the following Affinity Group:
    • Accreditation, Certification, and Enrollment Affinity Group: Provides its members with an organized forum to network and educate regarding legal developments and best practices relating to accreditation, certification, and enrollment issues affecting health care providers and health care professionals.
  4.  Check out the RAP PG Topical Library: This is where you can access the most relevant and recent AHLA publications and resources related to your practice area. It's the hub for AHLA content on AMCTH.
  5. Plan to attend Institute on Medicare and Medicaid Payment Issues (held each March in Baltimore, MD): The program will bring together knowledgeable public and private sector speakers with CMS and other agency representatives for the most comprehensive program available on legal issues related to reimbursement.    

In addition, here are other benefits available to you through the RAP PG:

  • Email Alerts, Executive Summaries, and Member Briefings: Timely alerts are delivered directly to your inbox—when a new law, regulation, or decision is published, we do the initial legwork and summarize it for you.
  • Great Opportunities for Involvement: The RAP PG leadership welcomes and encourages members to become active participants by writing, speaking, tweeting, serving as a mentor, and taking on other leadership roles. Visit www.healthlawyers.org/volunteer to view available volunteer opportunities.
  • Task Forces: For those health law topics that cross over several Practice Groups, AHLA has established Task Forces that produce collaborative, substantive resources for the benefit of the sponsoring Practice Groups' members. RAP PG members are automatically enrolled in
Getting involved in the RAP PG will enhance your knowledge in this highly specialized field and provide valuable networking opportunities.  We hope that your active participation in the RAP PG will help you in serving your clients' needs.


Summaries of the Office of Inspector General (OIG) Advisory Opinions are provided by the Advisory Opinions Task Force of the Fraud and Abuse Practice Group. The Task Force aids Practice Group members in keeping abreast of new Advisory Opinions. For each new opinion issued by the OIG, a summary is released via an email alert and posted on several Practice Groups' websites.

You may access this content by joining AHLA and enrolling in Regulation, Accreditation, and Payment Practice Group.


Already a member? Sign in

You may access this content by enrolling in Regulation, Accreditation, and Payment Practice Group.

You may access this content by Renewing your membership for Regulation, Accreditation, and Payment

You may access this content by joining AHLA and enrolling in Regulation, Accreditation, and Payment Practice Group.


Already a member? Sign in

You may access this content by enrolling in Regulation, Accreditation, and Payment Practice Group.

You may access this content by Renewing your membership for Regulation, Accreditation, and Payment

You may access this content by joining AHLA and enrolling in Regulation, Accreditation, and Payment Practice Group.


Already a member? Sign in

You may access this content by enrolling in Regulation, Accreditation, and Payment Practice Group.

You may access this content by Renewing your membership for Regulation, Accreditation, and Payment

  • Clinical Trial Agreements Toolkit
    - Published on March 10, 2016
    The Clinical Trial Agreements (CTA) Toolkit is designed to assist health lawyers with understanding and negotiating clinical trial agreements between industry sponsors and academic medical centers in instances where the industry party is the sponsor of a study involving an investigational drug. The CTA Toolkit is divided into 17 sections that represent key provisions of a CTA and is designed to provide the ideal provisions from both the industry-sponsor and academic medical center-clinical trial site perspective, as well as the reasoning behind those positions. The Toolkit also provides an overview of the business importance of each of these sections; relevant federal, state, or local laws; case law; international laws; other directives and resources; and operational considerations.
  • 340B Toolkit
    - Published on June 10, 2014
    The Toolkit is designed to assist health lawyers with understanding and researching 340B Drug Pricing Program (340B Program) issues. Although the 340B Program was established in 1992, the 340B Program has recently received increased attention from stakeholders and policymakers, creating a new interest in understanding 340B Program eligibility and participation requirements. This Toolkit provides the key statutes, regulations, policy guidance, case law, and forms necessary for legal counsel to understand the 340B Program.
  • EMTALA Toolkit
    - Published on March 24, 2014
    This toolkit provides practitioners with an updated, comprehensive set of EMTALA authorities, including, but not limited to, relevant statutory and regulatory authorities, the Centers for Medicare & Medicaid Services' (CMS') interpretive guidelines, and other U.S. Department of Health & Human Services, Office of Inspector General (OIG) and CMS pronouncements related to EMTALA.
  • Graduate Medical Education and Indirect Medical Education Payments for "Non-Provider" Site Training
    - Updated on March 15, 2013
    The updated version of the Graduate Medical Education (GME) and Indirect Medical Education (IME) Toolkit addresses Medicare payments to hospitals when residents provide services in "Non-Provider" site locations. This Toolkit includes relevant statutes, regulations, program documents, administrative and court decisions, links, and analyses related to Medicare GME and IME add-on payments to hospitals that rotate residents through these "Non-Provider" settings.
  • Diagnostic Testing Legal Issues Toolkit
    - Published on December 20, 2012
    The Toolkit is designed to assist lawyers in advising clients on diagnostic testing matters and in structuring diagnostic testing arrangements.The RAP PG wishes to thank the Physician Organizations PG for sharing this Toolkit with their members.
  • Provider-Based Status Toolkit
    - Updated on January 11, 2012
    The Toolkit follows a logical progression, starting with a discussion of why provider-based status is important, and continuing to a checklist of requirements for provider-based status, and then continuing to more complex issues, such as provider-based status for joint ventures, intersection of provider-based rules with physician supervision requirements, and attestations.
  • Medicare Claims Appeals Toolkit
    - Published on March 18, 2010
    The purpose of this toolkit is to provide a ready reference for the experienced practitioner as well as a “primer” for the newcomer to the field of Medicare claims appeals. With the implementation of the RAC process, providers are expected to experience an increased volume of claims audits. Consequently, there likely will be an increased volume in the Medicare Claims Appeals process, with a greater number of health lawyers being asked to represent their clients in the process.
  • Medicare and Medicaid Research Toolkit
    - Published on March 24, 2009
    This toolkit has been designed to assist health lawyers with researching complex Medicare and Medicaid issues. It is a web-enabled research guide that helps practitioners: (1) organize reimbursement research; (2) identify appropriate resources; and (3) carry out a successful and organized research project.

You may access this content by joining AHLA and enrolling in Regulation, Accreditation, and Payment Practice Group.


Already a member? Sign in

You may access this content by enrolling in Regulation, Accreditation, and Payment Practice Group.

You may access this content by Renewing your membership for Regulation, Accreditation, and Payment

Upcoming:

Past:

December 6, 2018 2:00 PM-3:30 PM Eastern

Upcoming:

Past:

Upcoming:

Past:

February 9, 2016 12:00 PM-1:15 PM Eastern
February 9, 2016 12:00 PM-1:15 PM Eastern

Upcoming:

Past:

December 5, 2018 3:00 PM-4:00 PM Eastern
November 8, 2018 3:00 PM-4:00 PM Eastern
November 7, 2018 3:00 PM-4:00 PM Eastern
October 3, 2018 3:00 PM-4:00 PM Eastern
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​Affinity Groups

Affinity Groups are created to facilitate networking opportunities with other Practice Group members who share similar professional interests.
Please note: You must be a member of the Regulation, Accreditation, and Payment Practice Group or a government, academician, student, or PG 15 member (all-Practice Groups access) to enroll in this Affinity Group. 

Task Forces

Task Forces are established for those health law topics that cross over several Practice Groups, and they provide collaborative, substantive resources for the benefit of the sponsoring Practice Groups members.
Please note: You must be a member of the Regulation, Accreditation, and Payment Practice Group or one of the other sponsoring Practice Groups to receive benefits produced by these Task Forces. 

  • Accountable Care Organization Task Force
    The mission of the ACO Task Force is to provide members with a wide array of information relating to accountable care organizations, integrated care models, and other initiatives designed to improve quality and lower costs, for better population health. The ACO Task Force analyzes the impact and trajectory of ACO and other integrated care developments nationwide, including commercial ACOs, Medicaid ACOs, and the Medicare ACO programs.

    The mission of the ACO Task Force includes informing members of any new or updated regulations, waivers, and guidance relating to the main federal ACO programs, including the Medicare Shared Savings Program and the Pioneer ACO program, as well as to provide information on a broader array of issues integral to ACOs, integrated care systems, population health, and payment models.

    The ACO Task Force provides webinars, written material, and sponsored in-person programming pertaining to the relationship between ACOs and population health, as well as other topics germane to ACO formation and development. Since the ACO Task Force mission is so broad, it often partners with other AHLA Practice Groups to provide deeper insight into the unique legal and policy considerations for ACOs.
  • Behavioral Health Task Force
    The Behavioral Health (BH) Task Force is committed to advancing the understanding of laws impacting behavioral health, including the delivery of services to those living with mental illness, certain neurological conditions, substance use disorders or developmental disabilities, and reimbursement for such services. A complex framework of federal and state laws concerning privacy, information sharing and exchange, reimbursement, involuntary commitment, and other subjects provides unique challenges to health care providers and payers of behavioral health services. Scientific, legislative, and other developments, including health care reform, have presented new issues and opportunities in this area, including primary and behavioral health care integration initiatives, insurance coverage parity mandates, changes to Medicaid, and evolving public policy, to name a few. The BH Task Force monitors and evaluates these laws and developments through written materials, webinars, and in-person educational activities so that AHLA members are better equipped to advise clients on behavioral health topics. In addition, the work of the BH Task Force serves to raise awareness about how behavioral health laws influence health improvement efforts, and will include collaborative efforts with AHLA's Public Interest activities.  
  • Enterprise Risk Management Task Force
    The Enterprise Risk Management (ERM) Task Force is committed to advancing the understanding and application of enterprise risk principles to the health care industry. The premise of health care ERM is that by evaluating all risk exposures confronting an organization and addressing these risks proactively, the organization will optimize its ability to provide safe, efficient, and effective patient care while preserving the organizational assets required to deliver such care. The scope of health care ERM is broad, and encompasses all risk domains (categories): operational, financial, technology, human capital, strategic, legal and regulatory. The ERM approach facilitates the development and implementation of pragmatic, reasonable, and realistic solutions to managing risk for health care organizations and providers. 
  • Health Care Reform Educational Task Force
    The Health Care Reform Educational Task Force serves as a single key point-of-contact for the Association membership for institutional resources regarding comprehensive health care reform initiatives at the state and federal levels. The Task Force works to educate AHLA members on proposed health care reform initiatives as well as report on ongoing experiences with recently enacted reform initiatives.

Webinars

Roundtable Discussions


LeadershipView Project Reports

Image of JudithWaltz
Judith A. Waltz Chair Foley & Lardner LLP San Francisco, CA (415) 438-6412 Email
Image of StevenAdams
Steven Blake Adams Vice Chair - Strategic Planning and Special Projects Phelps Dunbar LLP Tupelo, MS (662) 842-7907 Email
Image of DanielHettich
Daniel J. Hettich Vice Chair - Research & Website King & Spalding LLP Washington, DC (202) 626-9128 Email
Image of RossSallade
Ross E. Sallade Vice Chair - Publications Polsinelli PC Raleigh, NC (919) 832-1718 Email
Image of JeanneVance
Jeanne L. Vance Vice Chair - Educational Programs Salem & Green PC Sacramento, CA (916) 563-1818 Email
Image of MonicaWallace
Monica Ann Wallace Vice Chair - Membership McDermott Will & Emery LLP Chicago, IL (312) 984-7757 Email
Image of MatthewHorton
Matthew William Horton Social Media Coordinator King & Spalding LLP Washington, DC 202-626-9256 Email

 

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