Doug Hastings, a Member of the Firm in the Washington, DC office, was quoted in BNA's Health Law Reporter on major issues for health reform in 2010.

In the article, "Outlook 2010: Restructuring, Consolidation in Health Care Make Reform Top Health Law Issue for 2010," Hastings listed a wide array of areas that will likely be of key importance.

Citing soaring health care costs, including in the Medicare and Medicaid system, Hastings said reform should focus on the payment and delivery system, ''the real engine of true, long-term improvement in both the effectiveness and efficiency of care.''

Hastings also said he sees the tension between the collaboration needed to attain efficiencies and fraud and abuse concerns as continuing to grow as health care reforms are implemented. ''The challenge for the enforcement community will be to determine what is a 'good' incentive between a hospital and physician to encourage proper use and what is a kickback disguised as a proper incentive,'' he said.

Antitrust will remain a significant compliance concern, Hastings pointed out, because the enforcement community is likely to struggle as it learns how to vigorously prosecute improper actions without discouraging activities needed to adapt to health care system changes. In addition, traditional labor law issues—such as union-management relations—''will be very important and visible in 2010.'' Due to many implications for health care workers in the health reform bills, a high unemployment rate, the trend toward employed physicians, and staffing shortages.

Health information is also a key issue because of the promises it holds to improve quality and achieve cost-containment goals and because of the legal challenges it poses for lawyers throughout the health care delivery system. ''No area offers more upside to improved population health nor is fraught with more thorny legal issues'' than health information, Hastings said.

In 2010, health plan regulation will be a major issue, regardless of the passage of reform legislation, according to Hastings. ''The challenge will be to match state or federal mandates to expand access with the ability to deliver more cost-effective care. Systems of integrated care that coordinate the payment function with the delivery function . . . appear to have advantages as compared to payers and providers who negotiate in an adversarial manner,'' he said.

Looking further ahead, Hastings said that over the next five years potential breakthrough developments in biologics and genomics could create great new treatments but also complex legal issues related to FDA approvals; patent protection; coding, coverage, and payment; and privacy and security.

Hastings also expects that ''connected health,'' in which non-health care focused IT and consumer electronics companies seek to develop health care products for consumers, will impact health regulatory, government contracts, and FDA issues.

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