AHLA's Speaking of Health Law

Conversations with AHLA Leaders: Ari Markenson, Partner, Venable LLP

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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 Ari Markenson, Partner, Venable LLP. Ari is a member of AHLA’s Board of Directors. 

Ari talks about how his childhood walking the halls of hospitals and medical schools led him to health law, challenges related to recruitment and health law specialization, how AHLA’s online Communities helped him become more involved in the Association and grow in the health law community, his desire to develop young professionals for a lifelong career in health law, and what his plaque will say when he 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 trail 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 31 states. For more information, visit horn L p.com.

Speaker 2:

Well, welcome everyone today. My name is chip Husler and my guest today with me is Ari Markson from the Venable law firm. Ari is also a board member of HLA and, uh, we're really glad to have him here. Welcome Ari

Speaker 3:

Chip. Thank you. Um, excited to be here.

Speaker 2:

Great. Um, and Ari, we generally start out by asking folks to tell us how you got into health law. How did you get into health law?

Speaker 3:

So, um, I grew up across the street from a large academic medical center because both my parents are, uh, physicians, uh, one still practicing. One is not. And, uh, one of'em is both a physician and an attorney. Um, and I literally grew up walking the halls of, uh, uh, several different hospital buildings and, and some, some medical school, uh, uh, classrooms and things, and, and just was from moment. I was born essentially, uh, exposed to, uh, um, healthcare and eventually, uh, um, wanted to do something in healthcare, but wasn't very interested in being a clinician and, and, uh, um, like the law took some, some courses in law in high school and so forth and recognized that even before I went to college and law school, that it would be interesting if I could be a lawyer in high healthcare in some way. And frankly, at that point in time, didn't really understand what that meant exactly. You know, I couldn't tell you that. I knew that there were health lawyers, um, uh, uh, but, but I sort of assumed that there had to be lawyers that did things in healthcare in some way or another. So

Speaker 2:

That's great. Was there anyone that inspired you along the way other than your parents, you know, who obviously as doctors were inspired?

Speaker 3:

Um, yeah, it was very interesting. My, my, uh, mother who's, the doctor and a lawyer, uh, um, had been very involved in an organization of MD JDS and, and, and, um, and many of the folks who were involved in that organization had all the very varied crew careers in terms of, of what they were doing. I mean, some were corers, some were, you know, heads of departments of public health and, and, uh, uh, some were literally malpractice lawyers on both the plaintiff and defense side and, and, um, and I was exposed to a lot of those folks, um, and, and just got a real sense of, and early on, even before I had gone to law school, right. Just got a sense of folks that were doing things as lawyers in healthcare, in so many different ways.

Speaker 2:

Yeah. That's, uh, that's great. Um, was there sort of a key moment or maybe pivotal moment in your health law career when you sort of realized I'm in the right place, this I picked the right thing, and I'm glad I'm here. You sort of, that, you know, I've looked back at my career, there was sort of some pivotal moments. Was there sort of any pivotal moments in your career you could look at and say, Hey, that, that was really a key moment in my career.

Speaker 3:

Yeah. You know, I, I had, uh, um, uh, gotten involved with, um, the health law community, uh, in law school essentially. Um, and, uh, um, with, without, uh, singling him out, there was a, a, a lawyer who worked at the, um, health and hospitals corporation at the time in, in New York. And I was the, um, uh, I was a student at Brooklyn law and, and you could through a clinic at Brooklyn law, basically get to, to, to find a, a, um, you know, credit bearing internship in a bunch of different places. And, and, um, I had been able to get, get a, an opportunity to work in the legal department, um, in health and hospitals corporation, which was frankly, and it still is a pretty large legal department and, and a, and a, you know, a, a, an urban, you know, public, I mean, yes, quasi public, but really public hospital system<affirmative>. And, um, it was, you know, just a eyeopening in terms, it was my first exposure to folks that were really practicing health law right. In different ways. Um, but, you know, had had, uh, uh, uh, end of life issues in front of them had contractual issues in of them had litigation issues in front of them, employment issues in front of them all relating to essentially the business of this hospital system. Right. Um, and, and it, all of a sudden said to me, wow, you know, this, I, this is I, this is neat. You know, I want to do this. Um, you know, it was sort of just a, a, a, a, a, a proving the con the concept to me, right. The idea that I had in my head all along that I would do something as a lawyer in healthcare. Um, you know, when I saw what these folks were doing in health and hospitals corporation, I said, this is, yeah, this is what I wanna do.

Speaker 2:

That's great. Um, so along the way, have you had any challenges, I mean, you don't get to be a leader, I guess, without having a and some challenges. Can you give us a sense of some of the challenges you've had to overcome in your career and what you did?

Speaker 3:

You know, it's interesting, the health law community of particularly within HOA is an amazingly collegial community. There's a lot of wonderful people. Um, uh, I can give you a funny story about my beginnings of getting involved in, in a little while, but, but the, the, um, it really is an amazing community. And the, the health loss section with the New York city board as well, that I was very involved in and still very involved, same thing, very, very unique community of folks, um, and very collegial, but it, it, for a very long time in my career, it always seemed bizarre that there was a lot of young people interested in health law. And, and there always seemed to be a lot of seasoned healthcare lawyers, but nobody in between no up and coming lawyers, no, no, you know, no sort of, you know, you know, no sort of, this is the wrong word, but I'll use it. No, sort of midlevel experienced healthcare lawyers. And I always scratched what's left of the hair in my head and said, kind of, you know, what, where, where, what are we doing wrong? Um, in, in, in health law and in, and in the, in the, um, in our community where we don't have, you know, we're just, we, don't, there's something missing as to why we don't have these folks. And, and, and I guess getting back to really why I'm saying this in response to the question is, is that I've always founded a challenge wherever I had been in my career to find folks that I could recruit in that space because they, they it's almost like they didn't exist, you know? Um, and, and it, it still is a challenge. And, and that, I, it just seems very strange that there's very, very few healthcare lawyers that, that seem to, to just be in that, that space between, you know, a young healthcare lawyer and a, a, a, a partner, um, with, you know, 20 years of experience.

Speaker 2:

Yeah. I mean, I think I would was only in that space for about three months, and then my hair turned gray and nobody believed that was in the middle anymore, but<laugh>, I'm with you. I, that's a great insight. And I think it's absolutely true. And I wonder why that is, it's probably got something to do with how healthcare just, um, you know, sucks you into a certain, uh, level of, of the up very quickly. And suddenly you are, you get very experienced with things very fast, cause there's such a high volume of things going on, but who knows? Cause that's a great insight.

Speaker 3:

Um, and, and I think, well, one of the reasons why I think that's happening though, is that I, I honestly think we're, we're losing. Um, and it's, and it's a, it's it's as a result of what's happening, I think in, in the, the legal world as a whole. But, uh, but I think that we're losing the Swiss army knife healthcare order. And what I mean by that is, is that I define my practice by the types of clients I represent not by necessarily the substantive types of law that I do now. Yeah. I'm an a and a regulatory lawyer at heart. I'm not a litigator necessarily. Um, but my practice is more defined by a client in the healthcare industry, particularly in healthcare services, mostly coming to me and saying, Hey, can you help me with X rather than me saying, you know, I'm an M and a lawyer that can buy and sell healthcare companies. Right. Um, yeah. And I think that younger lawyers are being trained more now to be an M and a lawyer, um, uh, even in healthcare, right. That they're, they're being trained to be a litigator or an M and a lawyer or regulatory lawyer. Um, and they're not being trained or they're not being even sort of, um, uh, um, I'm losing my word. Uh, um, you know, they're not being encouraged to, to be a, you know, an industry focused lawyer rather than a substantive type of law lawyer. Um, and, and I think that we're losing something there by, by that. I think that there's, you know, that, that, um, and, and frankly, one of the reasons why I think you have lawyers, younger lawyers that that tend to, to, to not move up in the ranks is because, you know, in my own career, I've recognized that there are days where I've got an enormous amount of regulatory work on my desk and that's, what's keeping me busy. And there are days where I've, I've got transactions around my desk and a regulatory work that's keeping me busy. Um, and the ability to kind of, you know, represent the client type rather than the, the, you know, be, be stuck in a type of law, um, has allowed me to, to, to be busy and have things to do and enjoy what I do.

Speaker 2:

So, yeah, I think it's the volume of transactions that, that, that, or, or in, or cases in the case of, uh, things that aren't transactional that maybe is the driver of that, in some sense, I know I did a physician contracting work and there was someone else in the firm that did all the managed care contracts, cuz I never would've had the time for any of that. Given all the physician contracts out on my plate, I, it was a miracle. I was getting the ones that I had add done each that I got new each month done within 30 days or 60 days of getting them, um, so that I could get the next pile from the board 30 days later when they would meet again. So I think there's volume has something to do with it. But I think when you get past volume, you're right, there may be a feeling that people get that once they get in that sort of special, as they rely on others, when other problems come along, they have somebody next door who they can talk to about the other problems. An in-house, council's got a checklist of things they gotta look at, but they, they only handle one or two of those things themselves and they've got farm out the rest maybe, but I

Speaker 3:

Think circumstances there's something lost right. In the sense that you, you don't get at a well rounded understanding of your client's needs, infant, you know, needs and interests and, and, uh, um, their goals. And, and the sense that if, if, you know, if, if the only thing you are to your client is the, the, you know, the, the managed care contracting order. Um, then, you know, it's, it's harder for you to have a conversation with them about when they want to, you know, talk to you about leasing some new medical office building, right. Or, or, or, you know, you know, and, and, and, um, you just don't get a well-rounded understanding of who your client is and what they want and need. And those kinds of things, if, if you're, you know, so specialized, I at least I think,

Speaker 2:

Right, right. I had the pleasure to talk. Tell one of my stories for saying, had the pleasure to talk with a, a noted health flare a number of years ago. And we were talking about the stark while, which is pretty much all I do as evaluator. I do a lot of stark and kickback related stuff said, is there anything that drives you more nuts in the stark law? It's so complicated. And so he said, well, the HIPAA law, you know, is pretty complicated too. And I don't deal with that very often once in a while. But, uh, I said, yeah, I guess that one falls into the category of also confounding people from time to time, but I never thought about it much until we had that conversation. Um, so, so, you know, as a leader, you've learned a lot obviously, and you, uh, you, you're gonna still be a leader for a while going forward, but when you've talked to people who are sort of have aspiration in their mind of becoming a future leader, what do you recommend to them? What do you suggest they do as they think about maybe trying to be a leader to, and emulating what you've accomplished

Speaker 3:

In, in my long winded answer to this, I'll, I'll start out with the story I alluded to earlier that I didn't really give you, which is when I, when I was a very young lawyer just done with law school and done with my master's in public health program. Um, I got, I'd already been involved as a student in, in, in, in HOA. Um, by now when I was a young associate and a small healthcare boutique firm, and we communicated in, in the community, you know, the HLA community community via list serves, right. Email list serves. Um, and some of them were very active and some weren't right, and just so happened that I was very involved in a lot of long-term care in postacute care clients. And the practice group, there was very active and the Lister was very active. And, um, I was this young lawyer that said, you know, why not see how helpful people are gonna be, you know, and, and, and, and, and chose to, to ask questions and respond to questions and, and, and see, and, and, and all of a sudden recognized that this community of folks on the list serve, um, competitors are not, it didn't matter. They were incredibly helpful. Um, uh, uh, and, and I was equally as helpful on, on issues that folks raised about what they were doing in their practice. Um,<affirmative> and that, in that, that getting involved right, um, led to me just continuing to build on how I got involved in the association, what I did within the association, what I got from the association. Um,<affirmative> that brought me to, to, to where I am now, in terms of, of, of being a board member, um, the, the, I will, to this day say that unequivocally of the association has given me a heck of a lot more than I've ever given to it, even though I've spent a lot of time speaking and, and planning programs and being involved in different committees and so forth and so on, um, what I've gotten out of the association in terms of meeting, uh, um, uh, colleagues and clients and, and learning, uh, about new issues and just getting resources has been unbelievable. You know, I I've, um, uh, um, uh, the, the, the, the other piece of that story that's always amusing is that, um, when I finally moved on from the small boutique firm, I was at to a much larger national health law firm, um, one of the partners, and I will absolutely never forget this. Um, one of the partners in interviewing me says, oh, you're that guy that's on the Lister of like 24 7, you know, so, and, and I, I didn't know if that was a, a, a positive or a negative comment in the interview process, you know, like it was, it was this, like, you know, you're that guy that doesn't shut up kind of comment, you know, and, and, and, uh, um, and, uh, it was very, very interesting, you know, and, and, and I, but I thought to myself, you know, whether whether this particular guy had thought that at negatives, a negative comment or positive comment didn't really matter, because frankly, you know, what, what I was getting out of being involved in that community at that time, in fact, brought me to that interview, right. I, I wouldn't have had the opportunity to interview with that firm if I wasn't able to, to build myself into the healthcare lawyer, even at that time that I wanted to be by being involved in HLA. Um, and that involvement right. Speak and writing and, and getting involved in committees, um, is really what led me to the board eventually. Um, and I think that that is, uh, um, something that, that many of our younger members don't really, they don't, it's not that they don't want to do it. I almost think they don't understand that they can and do it, um, that, that, that there's so much opportunity to be involved in the association. Um, and, um, you know, and frankly the, the third year, you know, health law associate that's at some event that they're at to some educational event, when the programs HLA programs or something, you know, is not their necessarily, they're competitive they're colleague. Right. You know, and, and, and, um, you know, uh, as long as you're not, you know, divulging client confidences, right, you should feel comfortable to go grab a lunch and grab a dinner and talk about life as a healthcare lawyer. Right. Um, uh, uh, I still have a relationship with a, that I met at the Medicare Medicaid Institute program who was at, um, uh, uh, at the time, what was the healthcare financing administration wasn't even CMS yet. Um, and, uh, um, you know, they were like a first year young lawyer starting out at, at the agency. Um, and it was really neat to meet them because frankly over the years, I've been able to send them emails and say, who do I talk to about this? Or who do I talk to about that? Or, you know, not necessarily having them answer something for me, but having them at least helped me navigate the agency. Right. Um, and the same thing happened for me, you know, mid my career. I met someone who was a, um, a, uh, um, one of the regional, um, and even in a region that I didn't necessarily do a lot of work in, but one of the, um, uh, regional lawyers for HHS and, and one of the, their regional offices and, and he would do, uh, really was amazing about saying, Hey, you know, if that's your issue, try to get to this person. Right. Um, and frankly, without HLA, that never would've happened for me. Right. Um, and I think that, uh, um, you know, you get that out of HLA, but you also, if you're, if you're that involved in Agea right. Opportunities to, to build on your involvement, come your way.

Speaker 2:

Indeed. I think that's great insight, lots of stuff you said there that was just spot on point. I used to be a participant in list service too. And, um, well just suffices say, no, press is bad, press on a Lister. I think it always serves you well, unless you, uh, unless you really stick your foot in your mouth, but you probably never did. You probably were just very, um, response and, and it got noticed and, um, and it made a difference. And, and then, uh, with some of the later things you mentioned, I think were right, it on point with how, uh, I've seen lots of, um, people kind of participate and get involved and turn integrate things. Um, you don't have to start out participating in something big. You can start out with something small. I found. So that's great insight as well. Where do you see, uh, health law? And Agea kind of, of going in the future. What is your sort of outlook for things you're gonna be on the board for a little while? What do you still wanna accomplish?

Speaker 3:

Well, it goes back to, to a big point I made before that, that if there is one thing I I'd like to see us accomplish in the, in, from the leadership of the association, um, it's figuring out how to develop those young, very eager lawyers involved in the association or not involved in the moment, how to get them in. Right. Um, as well as, by the way, other types of, of professionals that are interested in health law, right. And health policy and those kinds of things, um, to develop'em into, uh, uh, um, uh, the next generation where we don't have that kind of what I keep describing is that sort of weird, you know, generational, uh, a whole, um, that, that we really, uh, if you, I, I don't know of one of my colleagues that are either more experienced than I am, or sort of around my age, that, that wouldn't tell you that they cannot find a mid-level associate, um, that, that has the, the right experience at the are looking forward to work with them. You know, they just can't recruit those folks. Um, and, and the, the conversation is not necessarily that, you know, there aren't good people out there it's that they don't even exist. Right. You know, it's not, it's not that folks are saying, you know, everybody, I mean, it's not so exciting. It it's that we, we can't, we don't right. Getting resonates. Right. Um, and so I I'd love to see us, um, really fix how we're, uh, um, developing or helping to develop, uh, younger professionals into, um, a lifelong career in health law. And I think, you know, I think that there's, there's something there's, something's happening. It's not going right in the sense that there's there, there, you know, for that generational hole to be there. Um, it means that folks are, are, you know, either leaving the practice of help or they're pivoting in some way that they're not developing into that next level. And, and I I'd like us to feel out why, and to figure out how to fix it.

Speaker 2:

I think that's a, a great thing. And, and I hope that's what Agea is really there to help do. I think that's what it's about. So great insight. Let's take this in a little lighthearted direction. You live in New York city. That's one of my favorite places to visit in the whole United States. What are your favorite places, H a takes you a lot of places, uh, from time to time. What are your favorite places to visit when you leave New York?

Speaker 3:

Um, well, I'll tell you they've changed over time. I used to make a, a, um, a ton of excuses to go to any H a program that was in, um, new Orleans. Uh, uh, the food new Orleans is insane, but, but my, my years ago, the, the, um, uh, uh, fix of, of grabbing a, a beignet made a big deal to me, but of course then, and it's, and it's actually, I still has a connection to a, um, at a annual meeting. I, I had been, uh, uh, sick for a while and not understanding why I was sick and at an annual meeting, I got extremely sick and ended up in the, the, um, hospital, uh, in, in San Diego, uh, right out of an annual during an annual meeting. And, um, eventually was diagnosed with celiac disease. Um, and, uh, that stopped my beignet, you know, uptakes. So, but, but, uh, so my, even though I still, I, I enjoy, you know, a good bowl of, of Gator gumbo or wherever it might be down in Louisiana. It's, uh, uh, my ability to go over to Kand to stop dramatically. Yeah. Um, yeah, but there's other, I mean, there's other, uh, uh, things that, um, you know, AAS, uh, um, the, the way that we kind of run across the country with programs, you know, and where in the west coast, then we're sort of mid, you know, middle of the country and then east coast, it's just a really neat way to change up where we are and what we're doing. And I've always enjoyed, um, being able to do that, because even though some of our programs are sort of, you know, for good reason, uh, uh, stuck in certain places, uh, not all of'em, you know, most of'em aren't, um, and the, the, I, I just really, it it's really great that we kind of move them around so that folks get a different, different, um, feel for where we're gonna be. And, and, and, you know, just changes up the, um, the experience,

Speaker 2:

Uh, to totally agree. And, uh, I think it's one of the fun parts being part of the association. So, um, what, here's another lighthearted one. What is the story for your walk-in music? Do you have any walk-in music, like a baseball player and, uh, and, and where does it come from?

Speaker 3:

<laugh>? Um, I am, uh, um, at heart a, a, um, a pretty, uh, um, in my head, uh, a mellow character, and it's funny, my walk-in music would, would probably be something that, that involved very little noise and a lot of just simple guitar. Um, and there's so many different things I could point to that, but, but, uh, um, it's, uh, uh, you know, there's, there's a lot of artists sort of singer songwriter type stuff. That's just strings, right. That, that, uh, um, would be something in that genre that, that it wouldn't be noisy. It wouldn't be loud. It wouldn't be jumping all over the place.

Speaker 2:

Yeah. You sound like me. I'm probably more Jimmy buffet than in glitter rock and roll. Right. Um, but that's, that's great. Uh, so when they induct you into the health law hall of fame, which it's gonna happen for every board member, um, at least I say, well, uh, what's your plaque on the wall gonna say,

Speaker 3:

Um, you know, I hope it says that, that he really tried throughout his career, um, to make sure were that there was a next generation, um, because that's always been very important to me. I I've done a lot of mentoring ina, as well as outside OFA folks, interested in health law, um, and, um, have, have done all I could do, I think, to hire young lawyers, interested in health law. Um, and I've really had a nice time watching some of those lawyers, you know, develop a, you know, one of'em is a partner in a healthcare practice. Uh, now that is really just, you know, really doing a great thing. One of them is a in-house lawyer, a law for a, a, a large health system in New York and others, a in-house lawyer at a health system in Boston. And, and, um, you know, it's just nice to see some of the young folks that I've met over time, even for were in law school, who wanted to be healthcare lawyers really achieve that, uh, you know, opportunity that, that interest that they've had.

Speaker 2:

Yeah. That's fantastic. Well, great to hear. Well, really thank you for being my guest today. It was great to have a chance to chat with you. Um, enjoyed it quite a bit, and, uh, look forward to seeing you at HLA things around. Thanks so much for coming in

Speaker 3:

Chip. Thanks. This has been great. I appreciate it.

Speaker 1:

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