NM Talks Healthcare

How New DOL Salary Rules Could Impact Healthcare Employers

Thu, 29 Aug 2024 19:19:00 +0000

On this episode of NM Talks Healthcare, Nelson Mullins partner Cara Ludwig and senior associate Alyssa Riggins discuss the Department of Labor’s new salary thresholds for exempt employees, including potential impacts for healthcare employers, and how to ensure compliance between now and the January 1, 2025, effective date.

Navigating Medicare and Medicaid Regulatory Audits The Devil You Know

Fri, 14 Jun 2024 21:08:59 +0000

In this episode, Nelson Mullins partner Knicole Emanuel and senior associate Melissa Scott analyze the framework of Medicare and Medicaid regulatory audits of healthcare providers by shedding light on the relationship between the Medicare and Medicaid Integrity Programs and the types of contractors driving the force of compliance investigations. Emanuel and Scott also provide an overview of the audit process and strategies for providers to manage compliance-related risks and defend against unfavorable audit decisions.

Elevate your Management Services Organization with a Value-Based Enterprise

Mon, 13 May 2024 20:38:58 +0000

On this episode of NM Talks Healthcare, Nelson Mullins partners Ed White and Mike Segal are joined by Jim Carr and Luis Argueso, consultants, partners, and co-founders of InHealth Advisors. During the episode, they discuss the concept of how a Value-Based Enterprise (“VBE”) can transform the relationship between a management services organization (“MSO”) and its friendly physician professional corporation (“PC”), how to integrate a VBE into the MSO-friendly PC structure to help change the narrative surrounding non-physician participation in healthcare delivery, how a VBE can create a low-risk regulatory environment in the MSO-friendly PC structure, how new VBE revenue generation opportunities can enable an MSO to improve alignment with its physician providers and lessen reliance on restrictive covenants, and how creating new collaborative opportunities can lessen dependence on acquiring physician practices and open possibilities for partnering with hospitals.

Emerging Trends in Medicare Advantage Risk Adjustment

Tue, 12 Dec 2023 21:20:45 +0000

In this episode of NM Talks Healthcare, join Nelson Mullins partner Christine Worthen and a Director at Berkeley Research Group, LLC Mandy Asgeirsson in an overview of Medicare Advantage risk adjustment, including history and recent regulatory changes impacting payers and providers. This episode takes a deeper look into the main areas of government investigation, what the changes mean for payers and providers, and offers practical takeaways based on what we are seeing in the industry.

Nelson Mullins’ AHLA Leaders Discuss Benefits of AHLA Engagement

Fri, 10 Nov 2023 17:10:00 +0000

In this episode of NM Talks Healthcare, Nelson Mullins Healthcare Practice Group Leader Tom Moran interviews partners Trish Markus and Christine Worthen and of counsel Heather Miller about their experiences as being in leadership roles with the American Health Law Association (AHLA). During their discussion they touch on collegiality, top-notch education opportunities, multi-tasking, and more.

Creating and Maintaining Privilege over Internal Investigations

Mon, 16 Oct 2023 18:52:15 +0000

On this episode of NM Talk Healthcare, Healthcare partner Hannah Cross leads the discussion with e-discovery partners Julia Hartley and Travis Bustamante on creating and maintaining privilege over internal investigations. Tune in to hear about practical steps companies can take on the front end to create privilege and the downstream impact that process and procedure implementation can create if the internal investigation becomes relevant to subsequent litigation.

The Rural Healthcare Initiative: Securing the Future of Healthcare in Rural America

Fri, 18 Aug 2023 18:11:07 +0000

On this episode of NM Talks Healthcare, join Raleigh partners Bob Wilson and Cara Ludwig in discussion of the Rural Healthcare Initiative and how a multi-disciplinary team of professionals is working to secure the future of healthcare in rural America.

Avoiding Antitrust Traps for the Unwary: Guardrails for Healthcare Transactions

Tue, 25 Jul 2023 19:01:30 +0000

On this episode of NM Talks Healthcare, join antitrust lawyers Denise Gunter and Carrie Hanger in their discussion of the current enforcement environment, the potential impact on parties to healthcare transactions, and recommendations for conducting due diligence and pre-integration planning in an antitrust compliant manner. It is no secret that the Biden Administration has ramped up the enforcement of the existing antitrust laws. Now more than ever, it is critical that parties looking to engage in healthcare transactions are aware of the antitrust laws and put appropriate precautions in place to avoid making missteps.

Employee Classification in the Healthcare Industry: W2 Employee or Independent Contractor and Why it Matters

Wed, 21 Jun 2023 14:55:28 +0000

On this episode of NM Talks Healthcare, join health care attorney Cara Ludwig and employment attorney Alyssa Riggins as they dive into issues of employee misclassification and the legal differences between an independent contractor and an employee. With enforcement actions for employee misclassification in the healthcare industry on the rise, tune in to learn more about this important topic.

Using Value-Based Enterprises as a Business Strategy

Tue, 23 May 2023 17:31:14 +0000

On this episode of NM Talks Healthcare, join of counsel Heather Miller as she interviews partners Ed White and Mike Segal about the vital topics of value-based care and value-based enterprises. Healthcare reimbursement is steadily moving towards reimbursement based upon providing a better quality of care at a lower cost – value-based care. Segal and White will also dive into changes in rules regarding the Stark and anti-kickback laws, the creation of the concept of value-based enterprise, and how healthcare providers and companies can use value-based enterprises as a business tool.

Transitioning out of the COVID-19 PHE

Tue, 25 Apr 2023 14:44:22 +0000

Join Hannah Cross and Courtney Tito as they discuss some key considerations for providers when transitioning out of the COVID-19 PHE. With less than a month before the PHE ends on May 11, 2023, providers should already be working on how to transition out of the waivers and flexibilities they relied on to keep going during the heart of the pandemic. Hannah and Courtney discuss the broader Stark Waivers and AKS flexibilities, some provider specific items and round out the discussion looking at enforcement.

The FTC’s Proposed Ban on Non-Compete Agreements: What Health Care Entities Need to Know

Thu, 23 Mar 2023 15:36:04 +0000

In this edition of NM Talks, antitrust attorneys Denise Gunter and Carrie Hanger share their observations on the Federal Trade Commission's (FTC’s) recent proposed rule that would ban almost all non-compete agreements, regardless of industry and type of employee. Non-competes are a standard feature in most physician employment agreements. Denise and Carrie provide practical guidance for health care employers who need to understand how the proposed rule may impact their operations.

The False Claims Act: Managing the Risk and Responding to a False Claims Act Case

Wed, 15 Feb 2023 19:34:28 +0000

In this episode, Nelson Mullins partners Gabe Imperato and Edgar Bueno share their knowledge of the False Claims Act and its relationship to organizational compliance, and what it means for compliance professionals and the journey involved when defending against allegations in a False Claims Act case.

Fasten Your Seat Belt: Healthcare in 2023 Will be a Bumpy Ride

Tue, 17 Jan 2023 16:55:12 +0000

Healthcare attorneys Heather Miller and Trish Markus describe their forecast for healthcare law areas of focus for 2023.