AHLA's Speaking of Health Law

Conversations with AHLA Leaders: Lisa Ohrin Wilson, Senior Technical Advisor, Centers for Medicare & Medicaid Services

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This special series highlights AHLA leaders who discuss key moments in their careers, current and future trends in health law, and AHLA’s role in their professional development. In this episode, Chip Hutzler, Director, Horne LLP, speaks with Lisa Ohrin Wilson, Senior Technical Advisor, Centers for Medicare & Medicaid Services. Lisa is a member of AHLA’s Board of Directors. 

Lisa talks about how her interest in legal aid led her to health law, the law school teacher who inspired her, why she finds a career in public service so fulfilling, how the future of health law is constant reinvention, and what her plaque will say when she is inducted into the “Health Law Rock Star Hall of Fame.”

Sponsored by HORNE.

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Speaker 1:

In this special series, ALA leaders discuss key moments in their careers, current and future trends and health law, and Ally's role in their professional development support for ALA. And this series is provided by horn, which provides proactive guidance and strategies to enhance efficiency, improve patient experience, increase market share, and position you for greater success. Horn healthcare serves over 600 clients across 30 for more information, visit horn L p.com.

Speaker 2:

So welcome everyone. My name is chip Husler from horn. This is our HLA podcast series. The second year of doing this, and I'm really excited to have my guest today. First, uh, in line is Lisa or Wilson. Someone, you know, well from CMS, someone I've known a long time over a decade and, uh, have had a long, great association with, and I'm really happy to have her with us. Stay Lisa, thank you for joining us.

Speaker 3:

Thank you for having me

Speaker 2:

And let me caveat and say, of course, Lisa's here in her personal capacity talking about Lisa and not speaking on behalf of the us government. So wanna make that crystal clear up front. Um, but with that, Lisa, let me start off by asking you how you got into health law. What were the things that kind of got you started going and thinking you wanted to be a health lawyer?

Speaker 3:

So believe it or not, I went to law school thinking I wanted to be a health lawyer. I was working for the federal government. I was a savings and loan examiner. I had been a finance major in college and so was working examining savings and loans during the times of distress back in the nineties. So I'm dating myself. Um, and I thought I wanted to go further. My education and law school sounded like a good idea, but I didn't know whether I wanted to, to continue, um, in the finance field or not. And as I researched different schools and where to apply university of Maryland law school and I'm from Maryland. So that was pretty helpful that it was local, um, had, uh, an emerging health law program and they had brought in Karen Rothenberg to start that program and run it. And with a very strong focus in issues of the moment at the time, uh, they had an aids clinic and they were providing legal assistance to persons with, uh, HIV and aids. And I thought that I wanted to go to that school and I wanted to potentially go into that type of public health law or, um, legal aid assistance type law. I ended up going to the university of Maryland working with Karen on a number of things, um, took a detour away from that, that particular area of health law, but worked myself through that program. And by the time I finished law school, I'd already taken 11 classes that were related to health law, and I was hooked. I knew that that's what I wanted to do.

Speaker 2:

That's great. It's one of the great health law programs. I went to the university of Maryland as well, but when I was there had no idea I would ever get into healthcare. I didn't know until almost 15 years later. Um, so although I knew Karen very well, I knew lots of people in the program I didn't take or, uh, participate in any of it. Um, I wish I had knowing where I ended up, but life takes you on strange trips. It's great that you were part of that program. I think it's one of the best programs. Um, so it sounds like along the way you had people who inspired you, Karen May have been one of them. Were there others that sort of inspired you along the way?

Speaker 3:

I would say, you know, early on it was Karen, Karen was the primary inspiration, what she had been doing with her career and what she intended to do with, uh, her career in health law, and all of the different people she knew and, and the experiences she had. And, uh, she was also my small section teacher in law school. And after a shell challenging start to transition from numbers and all the things I was good at to a particularly difficult way of thinking for me and writing for me. Uh, she sat me down in her office and there were tears and she told me that she was done looking at the tears. This would be the last of them that I was perfectly capable of doing this. And we do well. And I just needed to basically put on my big girl pants and move forward. And that is exactly what I did. And she was my mentor all through law school shortly thereafter. She helped me get my first in-house job in healthcare, my real first healthcare job. And, uh, she's just been, she was one of the early people who believed in me and set me on a course where I could kind of let go of that. Self-doubt and I think it's really important that that kinda connection happens early on in whether it's school or early on in a health lot career, the first person you work with, or your first boss, some early mentor. Karen was one of'em in another one was Patty brown who worked at the uni, um, in Maryland's attorney General's office. And she counseled the Medicaid program. And she was my boss when I was a law student who clerked there. And Patty also mentored me throughout the earliest stages of my career. She got me into teaching. She was teaching, moved on to work at Johns Hopkins in house and became super busy and recommended to take over her course at the university of Baltimore school of law. And that's how I ended up starting and teaching early, early on in my twenties still. Um, and so I had ended up having a lifelong love of being a professor as well. So both of them really set me up, um, with proper mentoring and inspiration

Speaker 2:

That's that makes complete sense. And I actually got to know Karen very well when I was in law school as well. She ultimately became the Dean of the law school for those who don't know and, uh, did a terrific job in that role for a number of years. Um, and it sounds like you had some really interesting, uh, mentors along the way and who really, you know, inspired you to be a leader. What challenges have you faced since then in, um, in your career that you look back and say, um, wow, that's amazing that we overcame that. And how did you do it?

Speaker 3:

Well, um, I would say there has been more than one occasion to, to be exact, um, where I just sort of picked the wrong path. I have never been afraid of changing jobs to try to learn something new in this profession or tried a different way to practice it or a, a sub-specialty. Um, and I have twice made mistakes about where I chose to go. And the important thing is to know that nothing is forever. Nothing is permanent, no mistake that you make can't be undone or just moved on from. And I think those two, the first time it happened, I very, very early in my career. And then second later, as I entered into sort of the, the more advanced stages of my career, and even at the advanced stage, you can make a change, you can correct mistakes and move on. And I think that's really important. And a lesson that students in particular, in those really early on in their health law careers need to understand is it's not all perfect and you shouldn't give up and you don't have to feel that you are in prison where you are, there's so much to do in this field. So many different work environments, so many different places to work. So many ways to work. So many specialties within health law, subspecialties that there's always something new to, to try and it's okay to try again and try something different. And I think learning that early on and surviving what seemed to be a catastrophe in my career, um, was very strengthening for me and that let me explore all the different things I wanted to do. And I have done so many different in this field and, and feel very lucky that I got to do that.

Speaker 2:

Was there one moment you could point to as kind of the key moment in your health locker, when you felt like you turned a corner and realized, Hey, this is why I do what I do.

Speaker 3:

Um, uh, you know, that's an interesting question. I, I would say, I didn't know that moment had happened until years later. And I will say, um, for anyone who's known me long enough to have, uh, known me through multiple jobs that I've had. And, and I'm in double digits, I will tell you that my resume is extremely long. Um, although it seems pretty stable now because I'm back at CMS and I love it. It'll be nine years in March. Um, yeah, looking back that turning point was when I was at CMS for the first time. And I changed from a career in practicing law, so to speak where I was counseling clients, whether in house or in a law firm to come into the agency and learn how to be a non-lawyer lawyer. What I do at CMS is not a legal job, but obviously I work solely in a legal area and work on regulations and create policy that is law. Um, it wasn't until years after I love left CMS that I had the perspective to say, that is what fulfills me. That's the final resting place. So to speak for my career that I, I wanna go back to that, that, it's what I do I think. Well, I think it allows me, um, to use everything that I've done up until that point until coming into the government, all of the experiences I've had and, and the different things I've seen and done to pull it all together and serve and being a civil servant. I didn't realize until I wasn't a civil servant, how much I really feel motivated and called to be that

Speaker 2:

I remember actually having that conversation with you at one point where I was trying to maybe find you a different legal job. And you said to me, I think I'm going back to government. And I looked at you and said, that's great. That's, we're gonna be so lucky to get you back in government because, um, it's been a, I think for the industry, a great thing to have you back in that role. And it's great that you found your calling for a lot of people. It's not their calling they out. And I'm glad that for you, it has been that because I think we need people that really love doing that, doing that job. I think. Thank you. Um, cuz I know I could never, uh, but in any event, uh, that's a really great answer to that question. So this may be you one tough to answer from your seat, but think about what's you, what's your outlook for kind of the future of health law going forward? I mean, where do you see it going? You're you're now on the board of HOA as sort of an important agency involved in this. You're obviously sitting an important place in the government. Maybe you have thoughts on it that you can't share, but what can you share with us about kind of where you see helpful going in the future? Um, you know, just generally not specifics,

Speaker 3:

I see it continuing on the path that it's had. One of the things I've always loved about health law. And I always tell students, especially when they ask or, or those who are just new to the career, new to this profession, that it's the best specialty to be in. And because it's constantly changing, you can have, you can call yourself a health lawyer and be a health lawyer. And I see that in air quotes throughout your entire career, and yet you will have done 50 different things. It all stems from either a payment system changing or um, how we deliver healthcare. And there's so many things that make up health law. And I don't see that changing at all. I think the future of health law just for us as lawyers is just gonna be constant reinvention of ourselves and what we do and how we practice. I think it's gonna continue to, um, stem a great deal from reimbursement and the government drives a lot of what we do as health lawyers, by what it chooses to pay for and how, and the Congress telling us what to do and how, and how to pay for things that creates the policy, see, um, you know, what will be paid for. And then we have to figure out how to deliver it, what kind of standards to set from when that's going to be payable. Um, so a lot of the, that type of compliancy work falls, you know, directly in line with the reimbursement and the coverage of Medicare in particular Medicaid. Um, but there's so many other things too that are just technology crossing over into healthcare now, and that creates so many different things for health lawyers to know. Um, so I think, I think we're just gonna continue to see a spread of widening of this profession, um, and just so many opportunities to try new things and see new things. But at the same time, holding onto our core are principles of, if you can understand the money, if you can understand the reimbursement. I think that gives everyone a really solid foundation as especially young health lawyers, um, to, to know what being a health lawyer is and to be able to succeed in that because I, I do think that is part of the core. Um, I just think there's just so much potential to do so many interesting and creative things in this field.

Speaker 2:

Yeah. That's what I spend my time on teaching people, the, the numerical side of it. I'm a numbers guy for sure. And it's so intertwined with, uh, legal side. Um, the reimbursement system is key and I think you point to a great thing here. What do you still want to accomplish as a health lawyer? I mean, and what do you say when you're sitting there looking, I'm now gonna be on the HLA board for a few years? What do you hope to accomplish ahead of you? Uh, you know, do you have goals sort of looking out?

Speaker 3:

I have goals for myself and, but really more so goals for other people. I think that, um, where I might be better used these days is mentoring training, um, helping out the younger generation of health lawyers, I love to teach and I love to help people find their way and the nice thing about where I am now and my job is that I get to do that quite a bit. I, our team, we have a number of young lawyers. Who've been to law school, but are prac they're not practicing. So obviously they work in the government with me. Um, we do a really substantial training program and try to make sure people are getting, um, some inspiration in that, not just training the exact physicians of it for a lot rules and technicalities, but, but other things about the agency and how it works and the world and how it works and health on how it works. And so I do enjoy that. I haven't been teaching at law schools or anything for a while, but I, I do hope to go back to that eventually. Um, so I, I think my goal, I guess for younger lawyers, is that they will fall in love with us and, and find a full and healthy and happy career and health law too, and enjoy it and stay with it and not feel the burnout and, and just discord and, and, you know, unhappiness that we hear so many lawyers feel after they leave law. Um, I really hope to inspire people to find their way and to stick with it for myself. I think it would be I'm going to, I, I hope to knock on wood, uh, stay with CMS and keep doing what I'm doing for a long time. I feel very, uh, confident that there's more work to be done. We're not just, you know, creating regulations to create them. We are responding to what's happening in the world. We have this opportunity that we've been, you've seen over the last few years to really try to, um, modernize where we are with the position self-referral law and then compliance efforts in general. We work so well now I think with our law enforcement partners, I, to hope that I get to keep doing this because my job is satisfying every single day and I really enjoy that. Um, and then I do hope that I'll get to teach again, and I feel so grateful that I'm now part of the ALA leadership team in the sense that, uh, we can support the organization, obviously with the board. We're not the agency, the organization itself, but that our ability to support that and, um, and do whatever we can and offer our experiences and my experiences in particular to the, uh, organization in any way that I can, um, finally kind of give back. I've gotten so much from this organization over the years, that it it's, it's finally my chance to give back and serve. Um, since, you know, when I was teaching at the law school, that was my full-time job. That was when I really got close to HLA. And Peter Lial was still there and Ann Hoover, and we started working together to find a way to make a path for the university of Maryland law students to participate at conferences and when they were held in Baltimore and, and from those early days, I felt like all I did was get, get, get from ALA announced my opportunity to be able to serve and give back.

Speaker 2:

That's great. Um, so a couple smaller questions to kind of wrap us up. One is HLA takes you a lot of places. Um, a lot of locations, we do things and, you know, for CMS probably you don't get to go to as many as maybe some of the others, but, um, and so maybe you have an aspirational place. That's your favorite place that you'd love to go to, but do you have any favorite places you'd like to go when you've been on the road with health lawyers, any favorite Hangouts on the way I set of others?

Speaker 3:

Where would I hope there's going to be another conference? Sure, sure.

Speaker 2:

If you can ever get back to in person.

Speaker 3:

Right. I know. Well, I hope we all get back together in person soon. Um, me too, some of my favorites have been new Orleans and Austin was a great, great venue when we were there. I lived in Boston and worked in Boston for a while. So I totally enjoyed that. Um, San Diego's beautiful. I have an adorable little grandson there, so it would not kill me if we got to go back there. Um,

Speaker 2:

I actually saw his picture today. That was amazing.

Speaker 3:

It's precious. He's so sweet. So sweet.

Speaker 2:

It's like, he's what like 10, 8, 10 months old or something.

Speaker 3:

I think he's eight months old. Yeah, that's right. Almost nine. And, um, so really there are always great places to go. Um, you know, wouldn't break my heart if we got to go to south Florida again. So, um, you know, I think they're, it's really that the group of people that you're with it doesn't almost matter where you are, but we've had some really good times and, and I look forward to getting back together with everyone in person. So

Speaker 2:

That's true. And, um, another, the question I've asked everyone else is when they induct you in the health law rockstar hall of fame, what's your plaque on the wall gonna to say,

Speaker 3:

Well, I think there'll be a name mine that was given to me by herb, who was the deputy administrator at CMS for a while. Um, during those times when we were doing a lot of, uh, regulation in the earlier my first go round at CMS, um, a lot of regulation, we were finishing phase three, implementing a lot of changes that we couldn't get into phase three, a lot of proposed and changed rules. And in that 2009 era. So we were always, uh, having to brief our leadership on our policy issues and what the public was saying and not happy with or happy with. And I would walk into a meeting and, and her wouldn't say anything at all, you know, he'd listen appropriately and make us to decisions and was fantastic to work for. And then after I left, he was so great. He came to my going away party. Um, it was at a bar nearby CMS, and a whole bunch of people were there in her game, which was very funny. He came up from DC and he told me that he had always in his mind, Nick, to me, nicknamed to me something that when I would walk in to start a briefing, he would think to himself uhoh here comes the princess of darkness because it was the position of, and he knew it was gonna be something controversial that I was gonna come in to tell him, or that there was gonna be an issue with some stakeholders here or there. So I think I would, um, put the moniker princess of darkness on my plaque, but hope that everyone would realize said that is a joke because I, I really, um, like to think of myself as something other than the princess of darkness.

Speaker 2:

I, I mean, I certainly think of you as one of the shining lights on those dark law, but, um, but certainly, uh, it's, it's a humorous nickname and I know everyone's gonna remember that we'll be playing the, uh, the, the Darth theater music when you come in, just, Uh, in all in all seriousness, thank you so much for joining, really appreciate your being on today. It was great to chat with you for a few minutes and really enjoyed it and look forward to the time we get to work with you and see you at HLA events going forward.

Speaker 3:

Me too. Thanks for having me.

Speaker 1:

Thank you for listening. If you enjoy this episode, be sure to subscribe to a HLA, speaking of health law, wherever you get your podcasts to learn more about ALA and the educational resources available to the health law community, visit American health law.org.