Payers, Providers, and Patients – Oh My!

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this episode, hosts Joe Records and Payal Nanavati talk with John Brennan about what health care companies need to know about FCA dismissals under the Granston memo.

Payers, Providers, and Patients – Oh My!: FCA Dismissals Under the Granston Memo

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this episode, hosts Joe Records and Payal Nanavati talk with David McFarlane and Sam Krause about fiduciary duties related to health care under ERISA.

Payers, Providers, and Patients – Oh My!: Fiduciary Duties Under ERISA

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this episode, hosts Joe Records and Payal Nanavati talk with Lex Eley and Stephanie Willis about what private equity firms need to consider when investing in health care.

Payers, Providers, and Patients – Oh My!: Private Equity Investing in Health Care

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this episode, hosts Joe Records and Payal Nanavati talk with Jacinta Alves about compliance programs and how the government looks at them.

Payers, Providers, and Patients – Oh My!: Health Care Compliance Programs

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this episode, hosts Payal Nanavati and Joe Records talk with Troy Barsky and Alice Hall-Partyka about how recent litigation challenging the constitutionality of the Affordable Care Act may impact providers and payers. The discussion focuses on the authority for innovative health care models and important fraud and abuse provisions that were enacted in the ACA.

Payers, Providers, and Patients – Oh My!: Some Potential Impacts of Legal Challenges to the ACA

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this "deep dive" episode, hosts Payal Nanavati and Joe Records talk to Shelley Rosenberg about how health care defendants can use ERISA preemption as a way to remove litigation to federal court.

Payers, Providers, and Patients – Oh My!: Removal under ERISA

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this "deep dive" episode, hosts Payal Nanavati and Joe Records talk to Barbara Ryland about benefits under Medicare Part C.

Payers, Providers, and Patients – Oh My!: Medicare Advantage Supplemental Benefits

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this episode, hosts Payal Nanavati and Joe Records discuss recent FDA guidance related to digital health with Jodi Daniel and Shaina Vinayek.

Payers, Providers, and Patients – Oh My!: FDA Digital Health Guidance

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors. In this episode, hosts Payal Nanavati and Joe Records discuss PBMs with Todd Rosenberg.

Payers, Providers, and Patients – Oh My!: Pharmacy Benefit Managers

In this episode, hosts Payal Nanavati and Joe Records sit down with former regulators Jon Foley, Rob Shriver, and Kristi Martin to discuss the goals and design of the Affordable Care Act’s MSP Program—and what can be learned from its ultimate failure. Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

Payers, Providers, and Patients – Oh My!: Multi-State Plan Program

In this episode, hosts Payal Nanavati and Joe Records sit down with Jodi Daniel and Ambassador Robert Holleyman to discuss how regulators—across the U.S. and the rest of the world—can overcome the challenges of regulating emerging digital health technologies without stifling innovation. Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

Payers, Providers, and Patients – Oh My!: Digital Health Innovation

In part one of this deep dive, hosts Payal Nanavati and Joe Records begin a discussion with Xavier Baker and Kevin Kroeker about medical loss ratio requirements. This episode touches on what an MLR is, some of the history of MLR requirements in health coverage, and some of the similarities and differences across markets. Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

Payers, Providers, and Patients – Oh My!: Medical Loss Ratios (Part 1)

In part two of this deep dive, hosts Payal Nanavati and Joe Records continue their discussion with Xavier Baker and Kevin Kroeker about medical loss ratio requirements. The first episode provided background on what an MLR is and some of the history of MLR requirements, among other things. This episode touches on how the MLR is determined for plans and some of the compliance risks that can arise under MLR requirements. Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

Payers, Providers, and Patients – Oh My!: Medical Loss Ratios (Part 2)

In part one of this two-part series on what providers should know about COVID-19, hosts Payal Nanavati and Joe Records discuss labor and employment issues with Eric Su. This episode touches on health care providers’ obligations as employers and some best practices for handling this pandemic.

Stay tuned for tomorrow’s release of Part 2 with Brian McGovern on Federal and State Guidance.

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

Payers, Providers, and Patients – Oh My!: What Providers Should Know about COVID-19 (Part 1)

In part two of our two part series on what providers should know about COVID-19, hosts Payal Nanavati and Joe Records discuss federal and state guidance with Brian McGovern. The first episode included a discussion of challenges that providers’ may face as employers. This episode touches on the various federal and state guidance issued in response to COVID-19 that may impact health care providers.

Payers, Providers, and Patients – Oh My! Is Crowell & Moring’s health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

Payers, Providers, and Patients – Oh My!: What Providers Should Know about COVID-19 (Part 2)

In this episode, hosts Payal Nanavati and Joe Records talk to Jacinta Alves and Matt Vicinanzo about provisions in federal legislation that are aimed at easing the pandemic’s impact on the health care industry, including the processes and requirements for the Provider Relief Fund.

Payers, Providers, and Patients – Oh My!: Who CARES: The Provider Relief Fund

In this episode, host Payal Nanavati talks to Amanda DiSanto and Joe Records about the potential implications of the Supreme Court’s recent decision in Bostock v. Clayton County, Georgia, which addressed the rights of gay and transgender individuals under Title VII of the Civil Rights Act of 1964. Specifically, Amanda and Joe discuss what the ruling may mean for Section 1557 of the Affordable Care Act, including HHS's recent revisions to the nondiscrimination regulations.

Payers, Providers, and Patients – Oh My! - Bostock and HHS’s Nondiscrimination Regulations

In this episode, hosts Payal Nanavati and Joe Records are joined by Todd Rosenberg and Sam Krause to discuss ERISA preemption of state regulation of pharmacy benefit managers (PBMs) in light of the upcoming U.S. Supreme Court hearing in Rutledge v. Pharmaceutical Care Management Association. Payers, Providers, and Patients – Oh My! is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

Payers, Providers, and Patients – Oh My!: ERISA Preemption of State PBM Regulation

In this episode, hosts Payal Nanavati and Joe Records are joined by Xavier Baker and special guest Tim Murray, Director & Senior Consulting Actuary in Wakely Consulting Group’s New York office, to discuss the actuarial perspective on the cost of COVID-19. Payers, Providers, and Patients – Oh My! is Crowell & Moring’s biweekly health care podcast, discussing legal and regulatory issues that affect health care entities’ in-house counsel, executives, and investors.

Payers, Providers, and Patients – Oh My!: Rating in the Time of COVID

In this episode, hosts Payal Nanavati and Joe Records talk to partner Michael Shaheen, who recently served as a Trial Attorney with the Fraud Section of the DOJ.  Michael sheds some light on what potential FCA targets can do to understand and rebut DOJ’s use of data analytics to pursue FCA investigations.

Payers, Providers, and Patients – Oh My!: Data Analytics and FCA Investigations

Crowell & Moring LLP is an international law firm with approximately 550 lawyers representing clients in high-stakes litigation and arbitration, regulatory, and transactional matters. The firm is internationally recognized for its representation of Fortune 500 and emerging companies as well as its ongoing commitment to pro bono service, diversity, value-based billing, and legal project management.