2019 CSHA Annual Meeting & Spring Seminar
Estancia La Jolla Hotel and Spa
April 5–7, 2019
Estancia La Jolla Hotel and Spa
CSHA is pleased to announce its 2019 Annual Meeting & Spring Seminar. Plan to join us for this in-depth overview of changes to California health law.
Please join us for the CSHA 2019 Annual Meeting & Spring Seminar
April 5-7 at the beautiful Estancia La Jolla Hotel & Spa. Weekend
sessions are scheduled in the mornings, leaving time for you and
your family to enjoy San Diego’s seaside village of La Jolla and
other local attractions.
In a time of continued uncertainty and change for the healthcare industry, we have selected a range of presentations to assist you in meeting the latest challenges and opportunities facing your clients. We are confident you will appreciate the breadth and depth of our MCLE-approved sessions, as well as the knowledge and experience of our presenters. Our topics are chosen to appeal to our members’ diverse practices, whether they represent health facilities, physicians, health plans or government agencies. And there will be plenty of time to network and socialize with well over 200 fellow practitioners in the healthcare industry.
We will hold a brief business meeting to bring you current information about our Society’s operations, finances and initiatives. Our always-popular Friday evening Welcome Reception and Saturday evening Annual Dinner (with live entertainment) provide opportunities to network with your health law colleagues. In addition, we will host a new member luncheon on Saturday afternoon. Attorneys who are new to CSHA, committee members, past presidents and current or former Board members are encouraged to attend.
Please read this brochure for further information on our program. Whether a novice or veteran healthcare attorney, CSHA’s 2019 Annual Meeting & Spring Seminar is sure to be a worthwhile investment of your time. I look forward to seeing you there.
Bill Helvestine, CSHA President
Friday – 4/5
7:45 – 8:45 a.m. | Registration & Continental Breakfast
8:45 – 9:00 a.m. | Welcome & Introductions
Bill Helvestine, President, California Society for Healthcare Attorneys
9:00 – 10:00 a.m. | Federal Health
Reform Update: Now What?
Jim Flood, Crowell & Moring LLP; Sonja Nesbit, Arent Fox LLP
Despite challenges, the ACA remains the law of the land – but there continues to be significant uncertainty about the direction of federal policies. This presentation will examine the outlook for health reform at the federal level, including legislation, executive/regulatory action, and judicial challenges. The discussion will look at the impacts of recent and potential changes on providers, payers, the uninsured, and other segments of the health care industry.
10:00 – 11:00 a.m. | State Health Reform
Update: What Will the New Governor Do?
Michael Daponde, Daponde Simpson Rowe PC; Felicia Sze, Athene Law, LLP
California continues to lead the nation in regulating and ensuring health care for its residents – and Governor Newsom wants to further the state’s progress. This panel will discuss the governor’s proposals to lower health care costs and increase access, including moving to universal or single-payer health care, consolidating the state’s prescription drug purchases into a state-run program, expanding Medi-Cal to undocumented immigrants, instituting an individual mandate/penalty, and appointing a California Surgeon General and a mental health “czar.” The legislature’s response to these proposals will be discussed, as well as California’s response to federal actions.
11:15 a.m. – Noon | Employer Benefit Issues
Craig Gottwals, Benefit Revolution
How have the ACA and other healthcare reform laws impacted employers – and how have they responded? Learn about healthcare reform’s impact on human resources and benefits, and what the future holds.
Noon – 1:15 p.m. | Lunch (hosted)
1:15 – 2:00 p.m. | Emerging Trends in Post-Acute
Benjamin Durie and Mark Reagan, Hooper, Lundy & Bookman, P.C.
Given CMS’s move toward paying providers based on the quality, rather than the quantity, of care, it’s more important than ever for hospitals and physicians to establish a clear post-acute care strategy. This presentation will discuss new and upcoming reimbursement changes for post-acute providers, including the SNF Value Based Purchasing Program and the Patient Driven Payment Model. The speakers will also describe the pros and cons of various types of legal structures available to coordinate with post-acute care providers.
2:00 – 2:45 p.m. | Administrative Litigation for
the Civil Attorney
Kevin Murphy, Murphy Jones, APC
This session is designed to provide a primer on civil litigation when one of California’s health care licensing boards has filed an accusation, statement of issues, citation, or other adverse action against your client. In this era of increased regulation, health care counsel should have a basic familiarity with how administrative actions should be handled, and when, if necessary, a referral should be made.
3:00 – 4:00 p.m. | A 360 Degree View of Using Independent
Monitors to Resolve Licensing Matters
Susan Bartholomew, Office of the Attorney General; Vincent DiCianni, Affiliated Monitors, Inc.; and Benjamin Gluck, Bird, Marella, Boxer, Wolpert, Nessim, Drooks, Lincenberg & Rhow, P.C.
Government regulators and health care attorneys are often faced with the challenge of finding an appropriate resolution of matters involving physicians and other providers subject to disciplinary action. One solution – independent monitoring – is being used with increasing frequency to resolve disciplinary or practice issues. Hear from an attorney who represents disciplined practitioners, a regulator, and an independent monitor about this different type of resolution that can allow practitioners to remain in practice or in a network while achieving remediation and demonstrating compliance with appropriate standards.
4:00 – 5:00 p.m. | Mental Health in the Workplace:
Dealing with Substance Abuse and Stress as
David Rosenberg-Wohl, Hershenson Rosenberg-Wohl,
A Professional Corporation
This session will explain the legalities concerning mental health issues as disabilities under the law and describe specific challenges that frequently arise in the legal workplace. Our speaker will touch on how to detect substance abuse and mental health issues that may impair an attorney’s ability to perform legal services with competence, and will offer guidance on what to do — develop thoughtful guidelines, policies and practices — and what not to do to avoid claims of discrimination while helping attorneys get the help they need. This session offers the special “competence” MCLE credit.
5:00 – 5:15 p.m. | CSHA Annual Member
Bill Helvestine, President, California Society for Healthcare Attorneys
5:15 – 7:00 p.m. | Welcome Reception (hosted)
Saturday – 4/6
7:30 – 8:45 a.m. | Breakfast Roundtables
9:00 – 10:00 a.m. | Health Litigation Update
Mark Kressel and H. Thomas Watson, Horvitz & Levy, LLP
The authors of CSHA’s email appellate case updates will will reprise their popular annual session highlighting recent appellate court decisions that will affect the California healthcare industry for years to come.
10:00 – 11:00 a.m. | New Knox-Keene Licensure
Regulations: A Sea of Change
Stephanie Gross and Charles Oppenheim, Hooper, Lundy & Bookman, P.C
The Department of Managed Health Care has embarked on a dramatic expansion of its regulatory reach with its recent rulemaking to define the types of risk-bearing arrangements that require licensure as a Knox-Keene plan. While licensure has been historically reserved for traditional HMOs or entities that accept capitation, the new regulation would require licensure in order to accept modest amounts of upside or downside risk or to engage in a shared savings arrangement. This regulation may require a provider to obtain a license to participate in a hospital risk pool arrangement, accept a bundled or episodic payment, participate in an ACO, or enter into other value-based payment arrangements. Our experts will educate you so you can keep your clients’ deals compliant with the new law.
11:15 a.m. – Noon | Network Adequacy Laws in
Kacey Kamrin, California Department of Managed Health Care
The Department of Managed Health Care is responsible for developing and enforcing network adequacy standards for various types of health plans. What are the current requirements for commercial, Medi-Cal, and Medicare Advantage plans? What are the policy considerations with respect to gray areas, variations between the commercial and Medi-Cal standards, the intersection of network adequacy and quality, and other facets of this issue? Our speaker will help us understand the DMHC’s work and thinking in this area.
Noon – 1:00 p.m. | New Member Luncheon for Pre-registered
Members who joined CSHA after April 2018 are invited to attend, as are retired attorney members, CSHA committee members, current CSHA Board members and past CSHA presidents.
6:00 – 9:00 p.m. | CSHA 2019 Annual Dinner
This year’s Annual Dinner, to be held at the Estancia La Jolla Hotel & Spa will feature barn dancing guided by nationally known “Caller” Ron Nelson and live music from the Black Mountain String Band. No prior dancing experience is required – and fun for all ages is guaranteed!
Sunday – 4/7
7:45 – 8:30 a.m. | Registration & Continental Breakfast
8:30 – 9:15 a.m. | Understanding New Fraud Laws That
Impact Behavioral Health Providers and Labs
Paul Gomez, Polsinelli LLP
This presentation will provide an overview of the changing legal landscape for behavioral health providers and labs, due to new state and federal legislation that prohibits patient brokering and the payment of referral fees. Types of conduct and arrangements that may result in elevated compliance risk, lessons learned, and strategies for navigating these recent changes will be discussed.
9:15 – 10:00 a.m. | You’re Fired! – How Principles of
Employment and Peer Review Law Intersect and Complicate
Shelley Carder, Law office of Shelley A. Carder; Michael Sullivan, Paul, Plevin, Sullivan & Connaughton LLP
As healthcare becomes more consolidated and physicians join large medical groups, the lines between employment and medical staff peer review principles intersect and can conflict. Although employment in California is presumed to be “at-will,” contractual obligations, whistleblower protections, and anti-discrimination laws limit this principle. Real-life vignettes will be used to frame the issues and identify strategies and possible resolutions for the challenges that arise in investigating, disciplining, and terminating physicians.
10:15 – 11:00 a.m. | The Stark “Group Practice”
Definition -The Key to In-Office Ancillary Services
Nicholas Alarif, McDermott Will & Emery
With the reemergence of physician practice management organizations and private equity transactions in the physician practice space, compliance with the in-office ancillary services exception is paramount. This program will discuss what it means to be a “group practice” for purposes of the Stark Law, including regulatory requirements and the consequences of non-compliance. It will also address the strategic advantages and challenges to operating as a “group practice.”
11:00 a.m. – Noon p.m. | Recognition and Elimination
of Bias in the Legal Profession and Society
Augastavia Haydel, LA Care Health Plan; Paul Pitts, Reed Smith LLP; and Felicia Sze, Athene Law, LLP
California law firms and in-house legal departments are among the most diverse in the country, yet we continue to face challenges in retaining and advancing diverse attorneys. This panel will address the recent developments and current status of diversity in the legal profession, efforts undertaken by legal organizations to promote diversity and inclusion, and how the decision-making of an organization and the individuals within it can integrate the goals of diversity and inclusion into an organization’s culture. This session offers the “special recognition and elimination of bias” MCLE credit.
Breakfast Roundtable Topics
Saturday April 6, 2018 | 7:30 am – 8:45 am
Unique Issues That Arise in a California Healthcare
Elspeth Delaney-Paul of Verity Health System and Tania Moyron of Dentons US LLP
The pending bankruptcy case of Verity Health System of California (the second largest hospital bankruptcy in American history) has raised several important issues regarding the sale of non-profit hospitals (or any hospitals) in bankruptcy: (i) what are the limits, if any, of the Attorney General on the sale of a not-for-profit hospital in a bankruptcy case, (ii) how does a bankruptcy proceeding affect the transfer of a Medicare provider agreement to a buyer; and (iii) how does a bankruptcy proceeding affect the transfer of a Medi-Cal provider agreement to a buyer. For example, outside of bankruptcy the transfer of a Medicare and or Medi-Cal provider agreement imposes successor liability on the party taking the provider agreement; in bankruptcy can that liability be stripped off? All three issues have been hotly litigated. This roundtable will discuss these cutting-edge issues — and any other healthcare restructuring issues the participants want to discuss.
Peer Review Potpourri
Carlo Coppo, Tom Curtis and David Balfour of Nossaman LLP
Come join your peer review colleagues to share updates, hot topics, and war stories. This group is always lively!
Medical Cannabis: Are You Dazed and
Lisa Matsubara of California Medical Association
For years, medical cannabis was a loosely regulated, confusing, and often abused legal structure that was not widely embraced by the medical community. This has changed as public opinion regarding the use of cannabis shifted as evidenced by increasing number of states legalizing medical cannabis as well as recreational cannabis use. Starting in 2015 California legislature passed the Medical Cannabis Regulation and Safety Act and Medicinal and Adult Use Cannabis regulation and Safety Act to heavily regulate the medical cannabis industry while California voters passed Proposition 64 legalizing recreational cannabis in the state. This roundtable will provide an overview of the law regarding recommending cannabis, recent developments, and a discussion on common issues that arise with regard to medical cannabis in the health care setting.
ADR in Healthcare: Hot Topics in Arbitrating and
Mediating Payor-Provider Disputes
Elliot Gordon of JAMS and Damaris Medina of Buchalter, A Professional Corporation
Most contracts between providers and payors include agreements that disputes will be resolved through arbitration. These disputes cover a wide range of subjects, from interpretation of contractual provisions, to proper coding, to the medical necessity of inpatient admissions and more. And some cases can encompass hundreds, and even thousands, of separate claims that are at issue. This roundtable will include a health care neutral and a healthcare litigator, and will discuss how the parties can work together with their selected arbitrator to help ensure an efficient resolution to the dispute. It will cover the full range of the arbitration process, including the design of an arbitration agreement, arbitrator selection, discovery, case management, claims bucketing and sampling, and use of expert witnesses. Options for non-contracted providers and payors to utilize arbitration to resolve disputes on issues such as reasonable and customary value of emergency services will also be discussed. Finally, the roundtable will include a discussion of best practices for mediating disputes between payors and providers.
Noon | Adjournment and Distribution of MCLE Certificates
Presentations will be available online only
You will receive an email before the event with instructions on how to download the presentations to your laptop/tablet for viewing on-site or to print and bring with you. Be sure to download the materials in advance; WiFi access on-site may be limited.
Register by March 11 and Save
Registrations received after March 11, add $55
Minimum Continuing Legal Education
The California Society for Healthcare Attorneys is a State Bar of California-approved MCLE provider. The Annual Meeting & Spring Seminar provides up to 12.25 hours of MCLE credit, including one hour of elimination of bias special units.
A $75 nonrefundable processing fee will be retained for each cancellation. All cancellations must be in writing and received in the CSHA office by March 17, 2019 and emailed to email@example.com. No refunds will be made after these dates. Substitutions are encouraged and may be arranged by contacting the CSHA offices.
Discount deadline is March 8
CSHA has reserved a limited number of rooms at the Estancia La
Jolla Hotel & Spa, available on a first-come, first-served basis
at a nightly rate of $259, plus resort fee and tax. The deadline
for reserving rooms at this rate is March 8, 2019. After that
date, reservations will be confirmed subject to general
Contact the hotel directly at (858) 550-1000 and ask for the California Society for Healthcare Attorneys (CSHA 2019) group rate.
CONFERENCE HOTEL UPDATE: The room block at the Estancia La Jolla Hotel & Spa is now full.
There are several hotel options for those still wanting to attend the Annual Meeting and Spring Seminar, including:
- Hilton La Jolla Torrey Pines 858-558-1500
- Sheraton La Jolla Hotel (858) 453-5500
- Hyatt Regency La Jolla Aventine (858) 552-1234
CSHA is fortunate to receive generous sponsorship of the 2019 Annual Meeting & Spring Seminar from the following firms:
American Arbitration Association
Athene Law, LLP
Arent Fox, LLP
Best Best & Krieger LLP
Buchalter, A Professional Corporation
California Medical Association
Carlson & Jayakumar LLP
Crowell & Moring LLP
Daponde Simpson Rowe PC
Davis Wright Tremaine LLP
Dentons US LLP
Doll Amir & Eley LLP
Fenton Law Group, LLP
Foley & Lardner LLP
Garner Health Law Corporatio
Hanson Bridgett LLP
Higgs Fletcher & Mack
Hinshaw & Culbertson LLP
Hooper Lundy & Bookman, PC
Horvitz & Levy LLP
Kennaday Leavitt Owensby PC
Kessenick Gamma & Free, LLP
King & Spalding LLP
Law Offices of Stephenson, Acquisto & Colman
Manatt, Phelps & Phillips, LLP
Mazars USA LLP
McDermott Will & Emery
Morgan, Lewis & Bockius LLP
Nelson Hardiman, LLP
Nixon Peabody LLP
Outwater & Pinckes, LLP
Procopio, Cory, Hargreaves & Savitch LLP
Prospect Medical Holdings, Inc.
Ropes & Gray LLP
Schiff and Bernstein, A Professional Corporation
Sheppard, Mullin, Richter & Hampton LLP
Theodora Oringher PC
Download 2019 Annual Meeting
& Spring Seminar materials.
PLEASE NOTE: Seminar attendees must log in to the CSHA web site to access these resources.