Redefining Health Law

This episode sits down with Elaine Dorr to discuss the CMS Request for Information on building a more effective Health Technology Ecosystem. They discuss what is missing from the RFI, real-world challenges like burdensome billing, persistent interoperability gaps, and how AI may help close those gaps.

This episode shares takeaways from the 2025 Healthcare Compliance Association (HCCA) Annual Conference, and recaps the panel presentation, Herding Cats, co-presented with Roshunda Drummond-Dye, Vice President of Compliance and Chief Privacy Officer at WellStar Health System. The session on coordinating across departments to create provider-based reimbursement efficiencies sparked meaningful conversations about the expanding role of compliance in system-wide integration and operational strategy.

This episode breaks down the impact of the 340B Drug Pricing Program, a critical federal initiative reshaping the healthcare consolidation landscape. From rural clinics to large health systems, 340B is influencing everything from care delivery models to market consolidation. This conversation offers timely insights for healthcare systems and healthcare consumers into how financial incentives under 340B are redefining outpatient care and driving strategic decisions across the sector.

In response to an aging population, traditional Medicare patients are incentivized to enroll in Medicare Advantage plans, which plans present new challenges for provider reimbursement. In this "Reimbursement under Medicare Advantage Plans" episode, we discuss provider issues with Medicare Advantage plan and relevant reimbursement issues.

Health systems are consolidating and expanding their footprint at record speed. This two-part series first examined the provider-based status requirements and related hot topics, and this second, final episode in the series examines Medicare provider enrollment strategies for maximizing reimbursement efficiencies.

Health systems are consolidating and expanding their footprint at record speed. At the same time, Medicare is cracking down on provider-based reimbursement incentives. This two-part series first examines the provider-based status requirements and related hot topics, and the second episode in the series examines strategies for maximizing reimbursement efficiencies for provider-based health systems.

The Stark Law: a strict liability statute that prohibits certain physician relationships that are otherwise legal in a non-healthcare-related business transaction. This episode examines the writing requirement of the Stark Law exceptions.

In this episode, we cover the Stark Law, which prohibits certain physician financial relationships. The discussion breaks down the writing requirement with particular focus on modifications to the terms of the arrangement where a formal written agreement has not been executed by the parties.

A small percentage of the population makes up a large portion of our nation's healthcare expenses. What primary care and chronic care management efforts can be effective in improving these statistics?

This episode is the third part in our three-part introductory series, titled "Chronic Care Management" and examines the legal and practical frameworks that shape the delivery of primary care and chronic care management services to individuals in both urban, suburban, and rural areas. The discussion covers the challenging reimbursement environment and escalating operating costs for preventative care and coordination of chronic illness, as well as the ongoing efforts to alleviate hospital overcrowding, as described in the first episode.

The second episode in our three-part series addresses healthcare delivery challenges in the post-COVID era. This episode focuses on the role of post-acute care providers and hospital relationships with post-acute care providers.

These relationships are aimed at alleviating hospital overcrowding by transferring patients from short-term acute care hospitals into facilities better equipped to address the patient's specific needs. This episode will be a high-level discussion on these interactions with a focus on changes in governmental policy, reimbursement, population health changes, and actions providers have taken before, during, and after the COVID pandemic.

Hospital overcrowding: Where are we now in a post-pandemic world, 15 years after the enactment of the Affordable Care Act?

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