Lynn Gordon, a partner at Ungaretti & Harris, is trained in health law and has been practicing in this area for 13 years.
What do you find the most interesting about your practice?
I find the constant development of health care rules and regulations at both the state and federal level very interesting — challenging, but interesting. Working with for-profit clients on how best to comply with the complex interplay of these rules while at the same time trying to run a profitable business, or not-for-profit tax exempt clients trying to maintain a sufficient margin so as to stay operational and to have adequate net revenue to continue to maintain quality facilities and competitive services, is always an interesting endeavor.
What makes a good lawyer?
I believe that the key to being a good lawyer is being able to clearly identify client goals, maintaining an up-to-date and comprehensive understanding of your practice area, and knowing the business of your client base.
What is the biggest legal news right now, and what is its impact?
Health care law is in a state of unprecedented evolution — the national health care plan being developed in Washington will likely result in some significant changes in the way health care operates in this country. While it is still unclear at this point exactly what will work its way into any final federal legislation, we have seen and can continue to expect more pressure on tax exempt organizations to cover the needs of indigent and uninsured patients. We have also seen and expect further developments in Medicaid eligibility requirements — extending coverage to a greater number of patients. The same will be true for Medicare and other federally funded health care programs. At the same time, the government is continuing its downward pressure on reimbursement rates for services, which unfortunately for some services (with Medicaid in particular) fail to cover costs. In reaction to this, we are seeing more and more private practices opting out of Medicaid and even Medicare programs, and hospitals and other providers struggling to reconcile such shortfalls through added pressure on commercial insurers to pay higher rates.
These and other changes will impact the commercial health insurance industry as the government dictates further beneficiary protections against uninsurability based on pre-existing conditions and the like. So far, the insurance industry is receptive to certain proposed changes in anticipation of the greater number of insureds driven by other more pro-insurer changes (e.g., employer incentives to provide health insurance).
Finally, as part of the overall effort to control costs, the government is continuing to tighten up rules and regulations governing fraud and abuse and physician self-referrals, and to engage in significant enforcement activity in this area. We fully expect this to continue as part of the plan to address health care on a national level.
