Key Health Law Issues for 2011

Throughout 2010 and continuing through the first quarter of 2011, we have seen the introduction of substantial, new developments in health care laws, policies and initiatives that will impact the health care sector through the remaining months of 2011 and beyond. To cite just one example, on March 31, 2011, which coincided almost precisely with the first anniversary of the passage of the Patient Protection and Affordable Care Act and the Education Reconciliation (together, the ACA), the Centers for Medicare & Medicaid Services (CMS), the Federal Trade Commission (FTC), and the Department of Justice (DOJ) issued hundreds of pages of new, proposed regulations and policies regarding the Medicare Shared Savings Program. That program is just one health reform initiative among many, and the proposed regulations are no doubt the tip of the iceberg of regulations to come.

Beginning with the passage of the ACA, the U.S. health care sector has been readying itself for unprecedented changes in the way that health care is provided, managed and funded. The jury remains out, however, as to whether many stakeholders are actually taking the necessary steps to adjust to the changing landscape. At the end of 2010 and beginning of 2011, two separate U.S. district court decisions that upheld legal challenges to the ACA’s constitutionality added to the uncertainty some stakeholders already had about the enormity and permanency of health reform. Obviously, the ACA did not replace existing health care laws; rather, it introduced numerous new programs and modified certain existing laws. Simultaneous with the legal effects of the ACA itself, the recession, other economic forces driven by U.S. demographics, technological developments, state and federal regulatory agencies, and other factors have and will continue to affect the health care sector in profound ways. Given these pressures and converging forces, the following is a summary discussion of what we see on the horizon as the top eleven significant health law issues facing providers, payors and other stakeholders for the remainder of 2011.