Payers, Providers, and Patients – Oh My!

Hosts Megan Beaver and Savanna Williams talk to Rachel Park and Lisa Umans about the regulation of the organ procurement industry, recent congressional interest in the space, and the latest updates from the Centers for Medicare and Medicaid Services (CMS).  This podcast episode features the following speakers: Rachel Park is a senior counsel in Crowell & Moring's Washington, D.C. office and a...

In this episode, hosts Payal Nanavati and Megan Beaver speak with Linda Malek and Matthew F. Ferraro about the latest federal and state developments in artificial intelligence (AI) policy affecting health care. The conversation covers the Trump administration’s AI action plan and Executive Orders on AI, new industry-specific and comprehensive state laws, and enforcement trends, with a focus on how...

In the second of a two part series on the impact of administrative law in the health care industry, hosts Payal Nanavati and Savanna Williams talk to Dan Wolff about the practicalities of seeking judicial review to challenge agency actions, the impact of Loper Bright, and the major questions doctrine. This podcast episode features the following speakers: Dan Wolff is a partner in Crowell & Mor...

In the first of a two part series on the impact of administrative law in the health care industry, hosts Payal Nanavati and Savanna Williams talk to Dan Wolff about how administrative law manifests itself on a day-to-day basis and how to interact with agency officials in a heavily regulated industry. This podcast episode features the following speakers: Dan Wolff is a partner in Crowell & Mori...

In recognition of World Elder Abuse Awareness Day (June 15), hosts Payal Nanavati and Savanna Williams talk to Jen Mika about best practices that providers should keep in mind to combat elder abuse, neglect, and exploitation. This podcast episode features the following speakers: Jen Mika is a counsel in Crowell’s DC office and is considered a leading authority on Elder Law in the District of Colum...

In this episode, hosts Payal Nanavati and Megan Beaver talk to Alice Hall-Partyka and Savanna Williams about the impact of Executive Order 14187 on access to gender-affirming care for individuals under the age of 19. Alice and Savanna delve into the implications of this EO, and others, on payors, providers, and potentially conflicting state laws.   Executive Order 14187: https://www.federalregiste...

In this episode, hosts Payal Nanavati and Savanna Williams talk to Aaron Cummings and Stephen Holland about the Trump and Harris campaigns’ approaches to issues affecting the health care industry. This podcast episode features the following speakers: Aaron Cummings serves as the co-chair of Crowell’s Government Affairs Group and was Chief of Staff to U.S. Senator Chuck Grassley (R-IA) from 2019-20...

In this episode, hosts Payal Nanavati and Megan Beaver talk to Alice Hall-Partyka and Spencer Bruck about the recently released Mental Health Parity and Addiction Equity Act (MHPAEA) final rule. Alice and Spencer delve into the key new provisions of the rule, including the requirements for Non-Quantitative Treatment Limitations comparative analyses and the focus on data outcomes. Relevant resource...

In this episode, hosts Payal Nanavati and Savanna Williams talk to Roma Sharma and Wietse Vanpoucke about the European Union’s Artificial Intelligence Act, which establishes a common regulatory and legal framework for AI within the European Union. This podcast episode features the following speakers:   Roma Sharma is a counsel in Crowell’s Health Care Group, where she advises a variety of health c...

In this episode, hosts Payal Nanavati and Megan Beaver talk to Jodi Daniel and Lidia Niecko-Najjum about how HIPAA and existing data privacy protections are shaping health care organizations’ use of artificial intelligence.  Jodi and Lidia discuss the various regulations at play and also provide practical takeaways. This podcast episode features the following speakers: Jodi Daniel is a partner in...

In this episode, hosts Megan Beaver and Savanna Williams talk to Jason Johnson and Linda Malek about the evolving regulatory landscape related to artificial intelligence (AI) in health care. In particular, Jason and Linda discuss the use of AI by organizations engaged in clinical research including key issues and emerging themes in this field.   This podcast episode features the following speakers...

In this episode, hosts Payal Nanavati and Savanna Williams talk to Paul Pollock and Wayne Pryor about how private equity (PE) got its start in the health care industry, current trends in PE regulation, and where listeners can expect to see PE to continue investing in the industry.    This podcast episode features the following speakers: Paul Pollock is a partner in Crowell’s New York office and co...

In this episode, hosts Payal Nanavati, Jodi Daniel, and Cara Tenenbaum talk to Ben Moscovitch, Devon Adams, and Noah Goodson about recent policy developments on decentralized clinical trials (DCTs). They also discuss the Crowell Health Solutions’ white paper* on DCTs, which issues to federal agencies a number of policy recommendations to advance DCT adoption and increase clinical trial diversity....

In this episode, hosts Payal Nanavati and Megan Beaver talk to Chris Flynn and Alice Hall-Partyka regarding the proposed updates to the regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA). We discuss the current regulatory environment, enforcement, and key takeaways from the proposed rule. For further reading, please see: New Proposed MHPAEA Rule Builds on NQTL Comparative...

In this episode, hosts Joe Records and Payal Nanavati talk to Rebecca Baskin regarding her recently-published article analyzing the true costs to companies of becoming the subjects of False Claims Act or Anti-Kickback Statue investigations.  We discuss the article’s methodology, findings, and key takeaways.    Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, disc...

In this episode, hosts Joe Records, Payal Nanavati, and Jodi Daniel talk to three members of the health information industry regarding the Trusted Exchange Framework and Common Agreement (TEFCA) published by the Office of the National Coordinator for Health Information Technology (ONC). This episode features Jay Nakashima (Executive Director of eHealth Exchange), Nichole Sweeney (General Counsel a...

In this episode, hosts Joe Records and Payal Nanavati talk to Kelly Hibbert and Jed Wulfekotte about how Medicare plan sponsors and Medicaid Managed Care Organizations can structure an affirmative recovery program to prevent and detect fraud, waste, and abuse -- among other things.   Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing legal and regulatory...

In this episode, hosts Joe Records and Payal Nanavati talk to Michelle Chipetine and Stacie Heller about recent developments regarding the nondiscrimination requirements of Section 1557 of the Affordable Care Act, including new rules proposed by the Biden Administration and litigation around the issue of discrimination on the basis of sex.   Payers, Providers, and Patients – Oh My! is Crowell & Mo...

In this episode, host Payal Nanavati talks to Shelley Rosenberg and Joe Records about changes to the medical loss ratio (MLR) requirements impacting commercial coverage, particularly the limitations on what expenses issuers can include in their MLR numerators. Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect heal...

In this episode, Joe Records and Payal Nanavati talk to Scott Douglas and Charlotte Freed about the mental health provisions in the federal gun safety legislation. The new law included billions in federal funds to support mental health care—a huge investment likely to have major impacts on the industry. Payers, Providers, and Patients – Oh My! is Crowell & Moring’s health care podcast, discussing...

This episode is the second part in a miniseries with Crowell Health Solutions, which is a strategic consulting firm that Crowell & Moring launched earlier this year to help healthcare organizations and technology companies transform health care by improving patient care and health outcomes, advancing health equity, and lowering health care costs through solutions like digital health innovations an...

In this episode, host Joe Records talks to Gary Baldwin about the regulation of shared-risk arrangements in the state of California. They discuss the history of shared-risk arrangements in California, how the Department of Managed Health Care (DMHC) approaches these kinds of arrangements, and the kinds of issues entities should consider in approaching shared risk.   Payers, Providers, and Patients...

This episode is the first part in a miniseries with Crowell Health Solutions, which is a strategic consulting firm that Crowell & Moring launched earlier this year to help healthcare organizations and technology companies transform health care by improving patient care and health outcomes, advancing health equity, and lowering health care costs through solutions like digital health innovations and...

In this episode, hosts Payal Nanavati and Joe Records talk to Katy Raffensperger, Todd Rosenberg, and Alexis Gilman about expectations for healthcare transactions in 2022.   The discussion captures how transactions involving health care companies may respond to legal, economic, and market circumstances, including lasting care delivery changes spurred by the COVID pandemic, antitrust scrutiny by fe...

In this episode, hosts Payal Nanavati and Joe Records talk to Matt Vicinanzo about developments in False Claims Act litigation – including materiality, scienter, and government dismissal authority, among others – and how those developments may have a unique impact on companies in the health care industry. For more information please see: "The Top FCA Developments of 2021,"  Government Contracts Bu...