Medicare, fraud and abuse remains top health law issues for 2010

Health care reform will change, if not send shock waves through, virtually the entire field of health care law. That is the consensus of 24 health law practitioners from BNA's Health Law Reporter advisory board, in a survey conducted in December 2009.

The majority of survey respondents applauded reform's major goals: increasing access to needed health care services, promoting provider coordination and integration, supporting a stronger role for primary care and improving care for people with chronic conditions or complex needs, holding providers more accountable for results, and increasing health system efficiencies. They debated, however, whether current reform initiatives would bring these changes about or whether congressional proposals will just create more problems down the road.

Rounding out the top half of the Top 10 list were: Fraud and abuse, Medicare, quality, and antitrust. These key issues are followed by health information, taxation, health plan regulation, medical staff, and labor and employment as front-burner concerns the health care system will be dealing with in 2010. All survey respondents agreed that health care reform will be an issue with reverberations throughout all of the others.

One board member describes a 'perfect storm' in health care fraud: an aggressive administration, changes to the False Claims Act that will drive a variety of new whistleblower cases, and a growing recognition that fraud is a significant driver of health care costs. Fraud and abuse is expected to remain a challenging reality for health care providers who may find themselves far too easily tripped up by increasingly complex sets of rules and the increased likelihood of a 'got you' enforcement approach.

All the top issues are discussed in detail in the full report. Press copies are available to working journalists. Email Karen James Cody at [email protected].