Katten special counsel Lisa Prather grew up wanting to be a doctor, but undergraduate chemistry changed her mind.
Still interested in healthcare, she went to law school and took all of the health law classes she could. A summer internship at Parkland Hospital and representing several healthcare clients at her first law firm job at Passman & Jones confirmed her passion.
But Prather could never have anticipated working as a healthcare attorney in the midst of a once-in-a-century pandemic. The Texas Lawbook visited with Prather in the following Q&A about the unique, evolving challenges of the past 20 months.
The Texas Lawbook: How did you end up specializing in healthcare regulatory and compliance matters?
Lisa Prather: I grew up wanting to be a doctor, but undergraduate chemistry helped change my mind. So, I went to law school hoping to somehow tie it to my interest in healthcare. I took all of the health law classes offered and had a summer internship in Parkland Hospital’s legal department. Fortunately, the firm I first worked for after law school had several healthcare clients and allowed me to assist with various regulatory and compliance matters for those clients. That confirmed my passion for this area of law, and I continued to grow my experience and practice in this specialty. When I later became board certified in healthcare law by the Texas Board of Legal Specialization, I felt I had a fairly strong grasp on most healthcare regulatory and compliance matters. But, two months later the pandemic hit, confirming there will always be more to learn and new challenges for my clients.
The Lawbook: What are one or two of the most interesting matters you have handled recently? What made them interesting?
Prather: Prior to the pandemic, one of our clients had started a telehealth services offering in a handful of states. The pandemic quickly accelerated the client’s initiative, so we assisted with their expansion into all fifty states. The different legal requirements for providers in each state, as well as the rapidly changing landscape of telehealth rules and guidance, made the work challenging but interesting. It was rewarding to know we were helping to address immediate needs of the client as well as its patients.
The Lawbook: Please describe your work on the eTrueNorth public-private partnership with the U.S. Department of HHS. Where does that deal rank in your career?
Prather: My work with eTrueNorth has been primarily on data privacy matters. Managing COVID testing locations across the country and facilitating how individuals make an appointment and receive their results, as well as the potential reporting of results to public health authorities, has various considerations under HIPAA and state privacy laws. Due to COVID and the public health emergency, the U.S. Department of Health and Human Services Office of Civil Rights published, and revised, certain waivers and notices of enforcement discretion regarding HIPAA and data privacy matters. We have assisted eTrueNorth in navigating these matters as the pandemic has evolved.
The Lawbook: How has your practice changed since the Covid-19 pandemic?
Prather: Non-stop, answers can change daily, and a LOT more video calls. Our practice group was instantly busier when the pandemic hit and it has not slowed down. Whether we’re analyzing the latest government order or helping a client pursue a new service offering, we have learned and adapted with our clients. I have also interacted more with other practice groups at our firm, such as our labor and employment attorneys and our data privacy group, as clients navigate matters for their own personnel (i.e., remote working, vaccine mandates, etc.) or focus on their technology capabilities and security. I have not seen my coworkers as often, but I have “seen” clients more often with everyone embracing video calls and virtual social interactions.
The Lawbook: What are you observing in the health care transactions space?
Prather: Many of my clients increased their focus on expanding the types of care that can be provided on an outpatient basis and being able to provide care to patients at home. There continues to be a lot of consolidation or “roll-up” of provider practices and creation of management services organizations. As the administrative aspects of practicing medicine increase in complexity, providers find it helpful to have another entity focused on those aspects so the providers can actually treat patients. This year has been busier than 2020 in the mergers and acquisitions context, due, in part, to private equity money not used in 2020 now being invested in healthcare initiatives and the anticipation of tax law changes that may take effect in 2022.
The Lawbook: Are private physician practices still being gobbled up by PE firms? If so, do you expect that to continue?
Prather: Yes, as indicated above, this year has had a lot of activity by private equity firms in the healthcare space. In past years, I had experienced it the most with clients in the anesthesiology and gastrointestinal specialties, but this year I’ve worked with deals in those specialties as well as behavioral health, ophthalmology and optometry, cardiology, radiology, and urology. I expect the trend will continue, but I think this year was somewhat of a “catch-up” from 2020, so things may level-off a bit next year.
The Lawbook: What are the key developments or trends in your health care regulatory practice?
Prather: Telehealth is officially here to stay, so more providers want to consider expansion into other states and alternative ways to interact with patients. Health information technology is also at the forefront of many discussions – everything from technologies to support telehealth and remote patient monitoring, to tools to analyze data in support of quality assurance or patient care metrics, and keeping data secure while also making medical records more easily accessible across providers in order to better care for the patient. Another rapidly evolving area is the use, and possible monetization, of healthcare data – how to leverage existing data for research initiatives, predictive analytics, or artificial intelligence learning – all of which have pros and cons in addition to legal complexities.
The Lawbook: What is keeping your clients up at night?
Prather: I work with healthcare providers, so the short answer is COVID. More specifically though, it is staffing, compliance with rapidly changing rules, and improving ways to care for patients. My healthcare system and large group provider clients continue to adapt to a variety of challenges affecting their employees. Whether it is having enough clinical staff to care for patients during a COVID spike or navigating vaccine mandates, the decisions affecting personnel continue to be of vital importance. Also, many clients are trying to increase their in-house legal departments to assist with today’s legal complexities. We have all witnessed laws and rules changing on an almost daily basis (e.g., emergency orders, temporary waivers, differing federal and state mandates, etc.), so a lot of time and effort goes into staying informed, adjusting as needed, and anticipating what might happen next. Despite those challenges, providers continue to care for patients, but are trying to do so in ways that are more convenient and efficient for all involved. That is why innovations in telehealth, remote patient monitoring, and at-home care options are frequently topics of discussion with my clients.
The Lawbook: Any lessons learned from your experience as deputy general counsel at Steward Health Care?
Prather: It is extremely beneficial to have outside counsel be part of the “team” and almost as familiar with the company as inside counsel, especially for companies with small in-house legal departments. This type of relationship helps in-house counsel know it has a reliable resource who is “invested” in the company’s success, and outside counsel, having a more complete picture of the issues or questions, can likely anticipate the company’s needs or provide faster, more tailored, responses. I am passionate about creating this type of relationship with my clients through frequent touch-base calls, task tracking tools, and other items that assist the client in managing their various initiatives or mapping out a new project. At times, I will even serve as a supplement to in-house counsel staff on an ad-hoc basis to assist with large projects or fill-in for inside counsel personnel who are on leave.
The Lawbook: Is there anything else you would like to add?
Prather: I am grateful to be practicing healthcare law, since that was my goal in going to law school, but the pandemic and my work related to it are not anything I ever anticipated. So, I’m even more thankful for the various attorneys I’ve worked with over my career, and those I currently work with at Katten, who have contributed to my legal knowledge and ability to assist clients regardless of the circumstances.
Publisher’s Note: Katten is a sponsor of The Lawbook’s Corporate Deal Tracker page. This Q&A is an associated thought leadership piece.