Institute Healthliners

Institute of Health Law Studies Given Alpha Project Service Appreciation Award

March 5, 2010. The Institute of Health Law Studies, a Center of Excellence of the California Western School of Law, was given the Alpha Project Service Appreciation Award today. The Alpha Project is a charitable organization that supports the needs of the homeless. The award stems from the activities of IHLS in its Warm A Heart Homeless Clothes Drive held each February, as well as its Feed A Friend Food Drive for the Homeless program held each July.

Professor Bryan A. Liang, IHLS Executive Director, and Pam Tait, IHLS Program Administrator accepted the award on behalf of IHLS. “This is a tremendous honor for IHLS,” said Dr. Liang. “We are fortunate to be in the position to be able to give back to our community, and working with the Alpha Project has been an important opportunity to address the needs of the homeless, particularly in these difficult economic times.” In addition, Ms. Tait indicated that “Over the past six years, we have been able to take advantage of the generosity of CWSL, and this award is really for those who contributed to these drives, recognizing the plight of the homeless.”

Professor Liang Interviewed by Lawyers USA on Botox Trials

March 4, 2010. More attention has been given to the Spears Botox verdict as lawyers prepare for the next set of lawsuits. Lawyers USA interviewed Professor Bryan Liang on what to expect in the next stages of litigation.

Professor Liang noted that although the Spears’ jury found adequate warnings by Allergan as to side effects of Botox use in pediatric cerebral palsy patients, he did not believe that this would be the conclusion of all juries who will consider the warnings. But he also stated that even if plaintiffs can convince juries that there was a failure to warn on the part of Allergan, proving causation of that failure and injuries suffered by ill patients will be difficult.

The story is “First Botox verdict goes to defense, but it’s just the beginning ,” by Nora Lockwood Tooher, in the March 4, 2010 issue of Lawyers USA.

KPBS Interviews Professor Bryan Liang on Congressional Investigation of Health Insurer Practices

March 3, 2010. Health insurers large increases in premiums and new revelations that they may be squeezing patients out of low cost plans into high cost ones with less coverage has ignited the health reform debate. The House of Representatives has announced hearings into these insurer practices. KPBS interviewed Professor Bryan Liang on these developments.

Professor Liang noted that the “perfect storm” of increasing insurance rates, health reform efforts, and millions of dollars in health insurer CEO bonuses annually has placed significant attention on health insurer practices. He also indicated that the hearings investigating these companies will be high profile, and will extend from Congress to State Capitols.

Professor Liang was interviewed by Kenny Goldberg, KPBS Health Reporter.

Executive Director Bryan A. Liang Comments on Botox Verdict in the Los Angeles Times

March 3, 2010. The case of Dee Spears, the mother of a 7 year old who died after Botox treatment for pediatric cerebral palsy, ended in a verdict for the manufacturer Allergan. The Los Angeles Times interviewed Professor Bryan Liang for his reaction.

Professor Liang, who is both a physician and an attorney, noted that this was first case to go trial of Botox treatment in these patients. Looking to future trials, he indicated that although the jury did not find that Allergan failed to warn, this conclusion may be challenged in other cases because the FDA mandated a black box, or special warning several months ago for the drug. He also noted that the jury in the Spears case did not reach the issue of causation, which will be challenging to prove. Finally, he noted that off-label promotion of Botox for pediatric cerebral palsy may have been done illegally by Allergan, which may serve as a basis of future investigations into Allergan’s marketing efforts.

The story is “Botox maker is not liable in girl's death, O.C. jury says,” by Lisa Girion in the March 3, 2010 edition of the Los Angeles Times.

Voice of America Interviews Professor Bryan Liang on Counterfeit Medicines

February 28, 2010. The concerns of counterfeit drugs are becoming a greater global public health issue. Voice of America interviewed Professor Bryan Liang for his comments.

Professor Liang noted that groups such as the World Health Organization, the Partnership for Safe Medicines, and others are working to educate the public and policymakers on means to address this growing concern. He indicated that the Internet is a key source of difficulty, both supplying materials for illicit use and as a forum to sell counterfeit medicines. He added that patients are the last barrier to harm, and the better educated they are on the taste, form, and normal reactions to the drug, the better able patients will be able to detect fakes.

The article was a second in a series on counterfeit drugs. The piece is entitled, “The Danger of Counterfeit Drugs (Second of Two Parts): A look at some of what is being done to fight fake medicines,” by June Gibbs.

Executive Director Bryan A. Liang Comments on Bipartisan Healthcare Summit

February 25, 2010. President Obama and Congressional Democrats have attempted to jump start healthcare reform through a bipartisan healthcare summit. KCBS asked Professor Bryan Liang for his reaction to this effort.

Dr. Liang noted that much of the event will be political theatre, with many of the speakers from both sides addressing the public rather than the participants in the room. He also indicated that focusing on narrow aspects of healthcare reform in standalone bills appears to be the best chance method for substantive changes in the health delivery system.

Professor Liang was interviewed by the KCBS News Team.

KPBS Interviews Professor Bryan A. Liang on Transplant Denial Case Against Blue Cross

February 24, 2010. The case of Ephram Nehme, the patient denied a transplant by Blue Cross California who then traveled to Indiana and paid for treatment on his own, has spurred interest in how insurers determine coverage for expensive treatments. KPBS asked Professor Bryan Liang for his perspective.

Professor Liang noted that the case provides a unique look into how decisions are being made by insurers with respect to expensive treatments. He pointed out that health care provider employees of Blue Cross who denied Nehme’s request had no experience in transplantation. Further, he noted that any external appeals would go to companies that make money off reviewing such requests for Blue Cross, limiting their neutrality. He called for reform to address these conflicts of interest and medical competency for review of patient care requests.

Professor Liang was interviewed by Kenny Goldberg, KPBS Health Correspondent.

Professor Bryan A. Liang Interviewed on New Obama Healthcare Proposal

February 22, 2010. With the upcoming “summit” on healthcare scheduled for February 25, 2010, President Obama released his version of healthcare reform. KCBS asked Professor Bryan Liang on his perspective regarding its provisions.

Professor Liang noted that the Obama plan was “simply warmed over leftovers of the Senate effort” with minor modifications that attempt to address House Democrat concerns. He indicated that the President’s efforts appear to be more political posturing, and doubted that the plan would be passed as outlined. Notably, Dr. Liang emphasized that there was very little bipartisan ideas within the plan, and the focus on using the Senate proposal indicated that the divisive climate in Washington, DC will likely continue.

Professor Liang was interviewed by Rebecca Corral and Melissa Culross of KCBS News.

Daily Journal Interviews Professor Bryan Liang on Google Policy Change for Online Drug Seller Advertisements

February 12, 2010. Google announced that it would no longer accept online drug seller advertising from non-National Association of Boards of Pharmacy Verified Internet Pharmacy Practice Sites. It interviewed Professor Bryan Liang on this development, as he and co-author Tim Mackey published the first article exposing the lack of search engine accountability for allowing such sales (Searching for Safety: Addressing Search Engine, Website, and Provider Accountability for Illicit Online Drug Sales, 35(1) AMERICAN JOURNAL OF LAW & MEDICINE 125 (2009)).

Professor Liang noted that this was a great win for patients, but that the job is not yet complete. Although Google adopted the recommendation in Professor Liang and Mr. Mackey’s article, other search engines as well as unscrupulous online sellers can continue to allow and promote illicit sale of drugs without professional oversight. Hence, he called for federal legislation to address the issue.

The article is “Google Moves Against Some Online Ads For Pharmaceuticals” by Evan George on page 1 of the February 12, 2010 edition of the Daily Journal.

Executive Director Bryan A. Liang Interviewed by KCBS on Report of High Insurer Profits and Questionable Insurer Activities

February 12, 2010. With the recent announcement that the top five health insurers posted record profits this past year despite the economic downturn, are increasing premiums up to 39%, and have cut coverage to at least 2.5 million patients, reform advocates are calling for investigations of insurer practices. KCBS interviewed Professor Bryan Liang on his reaction.

Dr. Liang noted that these figures were telling because neither side of the political aisle has defended these profits and actions, and both have reacted by calling for reform and investigations. In addition, he noted that these figures also must be assessed in the context of millions of dollars of insurer CEO bonuses, and industry analysts indicating that a shareholder and Wall Street focus means that health insurers “can never act in the best interests of their customers.”

Professor Liang was interviewed by Rebecca Corral and Melissa Culross, KCBS News.

Professor Bryan A. Liang Interviewed in Los Angeles Times Story on Indictment of Michael Jackson’s Physician for Involuntary Manslaughter

February 10, 2010. The death of Michael Jackson and the investigation of his physician, Conrad Murray, MD, has finally led to charges against Dr. Murray for involuntary manslaughter. The Los Angeles Times interviewed Professor Bryan Liang for his reaction on the case.

Professor Liang, who is both a physician and attorney, indicated that Dr. Murray’s account to law enforcement and fellow physicians associated with emergency care has created challenges for his defense. The timeline presented voluntarily by Murray would be an important focus for prosecutors. Further, Professor Liang noted that Dr. Murray’s omission of any statement about his administration of the anesthetic Propofol to Jackson during emergency efforts strongly implied he knew it was inappropriate for use outside the hospital setting.

The story is "Michael Jackson's doctor's case may hinge on his police statement," by Harriet Meyer and Jack Leonard in the February 10, 2010 issue of the Los Angeles Times.

IHLS Executive Director Bryan Liang Interviewed on “Dual Track” Healthcare Reform Strategy

February 4, 2010. Democrat efforts to jump start healthcare reform have included efforts to pare down proposals while also considering a “dual track” strategy of House passage of the Senate bill, and then using the budget reconciliation process to “fix” objectionable measures resisted by House democrats. KCBS interviewed Professor Bryan Liang on his reaction to this approach.

Professor Liang noted that narrowly focused bills might have a chance at passage. However, the dual track strategy is unlikely to garner support because the reconciliation process is not meant for creation of new programs. Further, moderate Democrats are concerned that such end runs will hurt their reelection efforts in November after the election of Republican Scott Brown in Massachusetts. Finally, Professor Liang added that the Democratic strategy to use reconciliation may be “painting themselves into a corner” because current reconciliation provisions expire in April, creating another deadline for Democrat healthcare reform efforts.

Professor Liang was interviewed by Stan Bunger and Susan Leigh Taylor, KCBS News.

IHLS Sponsors San Diego Blood Mobile

February 4, 2010. IHLS joined forces with the student Health Law Society to host the first blood drive for 2010. IHLS and HLS blood drives have become a tradition at the law school, and there was broad student and faculty participation.

IHLS continues to strive to make a difference in our community and will continue with quarterly blood drives. Last year, IHLS was designated Life Line Level 4, the highest level achievement for blood donations.

IHLS Hosts San Diego Network of CME Professionals Quarterly Meeting

February 2, 2010, IHLS hosted the first meeting for 2010 for the San Diego Network of CME coordinators in Mission Valley. IHLS is a leading CME provider in San Diego County. At the event, there were two guest speakers from The Doctor’s Company in Napa, CA, including Institute Member Ms. Arlene Luu, RN, JD.

The meeting contained in-depth discussion on the new CME Accreditation process, as many health provider groups are currently going through re-accreditation under the new rules. The new CME criteria has brought many challenges to the forefront and the meeting provided an opportunity to share resources for use in this process. Pam Tait, IHLS Program Administrator, is a designated CME Mentor.

6th Annual Warm a Heart Clothes Drive Begins

February 1, 2010. Throughout the entire month of February, IHLS will collect clothes donations for Alpha Project. Alpha Project is a philanthropic organization that services the San Diego homeless community.

There are over 17,000 homeless persons in San Diego and IHLS strives to provide assistance to this vulnerable group. The CWSL community can contribute by making clean and used clothing donations to benefit the less fortunate.

IHLS Honored as Member-at-Large Auxilliary Volunteer at Rady Children’s Hospital Annual Meeting

January 26, 2010, Program Administrator Pam Tait attended the Rady’s Children’s Hospital Annual Meeting at the Sheraton Harbor Island Conference Center. IHLS was recognized as the Member at Large Auxiliary volunteer.

The event was well attended, with over 400 participants and speakers. The meeting was highlighted with words from the children themselves and many heart warming stories were shared from them and their families. In addition to IHLS, leading physicians and experts were also presented awards.

Professor Bryan A. Liang Interviewed by KCBS on California Health Care Single Payer Bill

January 22, 2010. With health care reform being put into disarray federally after the election of Republican Scott Brown in the Senate, California has introduced a single payer bill for the state. KCBS interviewed longtime health policy observer Professor Bryan Liang on his reaction.

Professor Liang noted that this was not the right time for such a bill. Although health care reform is important, a bill costing a minimum of $210 billion in its first year at a time of economic hardship and high unemployment in the state is “inopportune at best.” He called for enforcement of current laws against insurer abuses and expanded access programs in cooperation with federal authorities until national reform efforts are clarified.

Professor Bryan A. Liang and Research Associate Tim Mackey’s Science Paper Featured in North County Times

January 20, 2010. IHLS Executive Director Bryan A. Liang and IHLS Research Associate Tim Mackey’s paper, "Reforming Off-Label Promotion to Enhance Orphan Disease Treatment," published in the prestigious journal Science, was featured in the North County Times.

Dr. Liang and Mr. Mackey addressed the key problem of orphan diseases, defined in the USA as diseases afflicting less than 200,000 patients, and lack of treatment for these conditions. They proposed a system of "off label promotion," i.e., promotion of drug uses not yet approved by the FDA, as long as there are rigorous standards in place for risk management and patient safety purposes in orphan disease patients. This would increase access to important medications for these patients as well as provide an infrastructure to collect information to determine effectiveness.

The academic journal Science is one of the most prestigious journals in the world. It has consistently ranked 1st in impact in multidisciplinary sciences for the last 30 years, according to Thomson Reuter's Journal Citation Report.

The North County Times piece is entitled, "Going 'off-label' can help treat orphan diseases," by Bradley J. Fikes in the January 20, 2010 issue.

IHLS Sponsors Two H1N1 Flu Vaccine Clinics on campus
January 20, 2010.

Januarty 20, 2010. On January 12th and January 20th, IHLS sponsored a collaboration between California Western School of Law and Pacifica Medical to administer the H1N1/A Flu Vaccine to all students, faculty and staff.

This effort was an enormous challenge for health providers to obtain the vaccine since the supply was so limited. With constant communication each week, IHLS was able to obtain enough to vaccinate the CWSL community.

IHLS Executive Director Bryan Liang Gives “Pay-for-Performance” Presentation at 2010 UCSD Anesthesia Update Conference

January 15, 2010. With health care reform very much on physicians’ minds, payment methods took on a very important role at the annual UCSD 2010 Anesthesia Update Conference, which attracts providers from around the country. Dr. Bryan Liang, Executive Director of the Institute of Health Law Studies as well as a member of the UCSD Department of Anesthesiology, gave a timely presentation on cutting edge developments in the area.

“Pay-for-performance, which attempts to push health care providers into providing care consistent with health care guidelines and to reduce costs, is here to stay. However, there are still a few bugs in the system,” Dr. Liang noted. “Yet in the current health care reform climate, fixing these bugs is less a priority than finding means to expand pay-for-performance methods to reduce costs. Health care providers must look for opportunities to partner to obtain efficiencies in care that promote consistent and improved outcomes,” he added.

Dr. Liang’s presentation was entitled “Pay, Performance, and Politics: The History and Future[?] of P4P.” Dr. Liang was asked to present at the 2010 Anesthesia Update by Dr. Gerry Manecke, Chairman of the UCSD Department of Anesthesiology.

Los Angeles Times Quotes Professor Bryan Liang on Insurance Rescission Appeals Court Case

January 2, 2010. As the new year dawns, health care reform continues to remain on the policy agenda. A recent California Appeals court holding allowing the Los Angeles City Attorney to bring fraud charges against health care insurers directly for inappropriately rescinding health insurance policies is the latest in the battle over insurer practices. The Los Angeles Times asked Professor Bryan Liang, a noted expert on the topic, to comment.

Dr. Liang noted that the court ruling has provided clarity as to the scope of permitted action by public actors other than state regulators to safeguard their citizen’s rights. With the ruling, the appeals court added “new cops on the beat,” according to Dr. Liang, and provided additional protections for patients with individual health insurance policies that were wrongfully rescinded.

The story is “Health insurers' rescission practices are exposed to more scrutiny,” by Lisa Girion in the January 2, 2010 issue of the Los Angeles Times.

Professor Bryan Liang Interviewed by KCBS on Senate Healthcare Reform Vote

December 24, 2009. With the pressure of the end of the year and promises made by Democratic leaders, the Senate healthcare reform bill was finally passed. KCBS interviewed Professor Bryan Liang on what to expect next.

Professor Liang noted that the holiday recess will be a time of back room negotiating, and that reconciling the House and Senate bills will be challenging. He pointed to key issues such as abortion coverage, state versus federal insurance exchanges, and financing reform that are still to be addressed in the two versions. He indicated that despite deep party divisions, Democratic leaders will likely try and push through a compromise by the President's state of the union address.

Professor Liang was interviewed on KCBS on the Rebecca Corral and Melissa Culross program.

Professor Bryan A. Liang Publishes Opinion Editorial in Forbes on Drug Importation

December 18, 2009. Healthcare reform efforts in the Senate, seeking cost savings, considered drug importation. Sen. Byron Dorgan introduced the proposal through an amendment to the Senate bill. However, this amendment had challenges from both sides. After debate, the proposal was defeated. Professor Bryan Liang published an opinion editorial commenting on the Senate’s actions.

Professor Liang lauded the Senate for understanding the safety concerns of importation. He also noted that Department of Health and Human Services Secretary Sebelius and FDA Commissioner Hamburg both considered the policy a challenge to patient safety.

The opinion editorial is entitled, “Say No To Counterfeit Drugs”, published at Forbes.com on December 18, 2009.

San Diego Business Journal Interviews Professor Bryan Liang on Genetic Information Nondiscrimination Act Weaknesses

December 14, 2009. The federal Genetic Information Nondiscrimination Act went into effect recently, but use of genetic information by insurers to discriminate against persons has been questioned. The San Diego Business Journal interviewed Professor Bryan Liang on these concerns.

Professor Liang agreed that GINA was not totally protective, and in fact, any individual life, disability, and long term care policy application may include such questions and makes applicants vulnerable to genetic discrimination. He also noted that, worse yet, because these policies include disclosure to an insurer database seen by all of its members, policy rejection can occur without an explanation. Professor Liang called for increased GINA protections for these other policies.

The story is “Genetic Privacy Raises Questions About Insurers” by Heather Chambers in the December 14, 2009 edition of the San Diego Business Journal.

IHLS Sells Raffle Tickets to Benefit Rady Children’s Hospital

December 12, 2009. It was a spectacular evening of holiday entertainment for the whole family at the 20th Annual “Carols By Candlelight Concert” on Saturday, December 12, 2009. IHLS members, led by Program Administrator Pam Tait, wore their red aprons during the event to sell raffle tickets at the California Center for Arts in Escondido.

The raffle included autograph CDs, ornaments and a Taylor guitar from the performers of the evening. These included country western singer and Grammy award winner Lee Ann Rimes, Little River Band, Buck Howdy, Jordan Pruitt and Bucky Covington. After the concert, IHLS members participated in the candlelight vigil outside of the art center to light up the holiday Christmas tree.

All raffle proceeds went toward supporting the Rady Children’s Hospital Programs. It was a glorious evening to honor the sick children in San Diego County and to wish them all a healthy New Year 2010.

Executive Director Bryan A. Liang Gives Emergency and Disaster Preparedness Presentation at Rady Children’s Hospital Advanced Trauma Symposium

December 11, 2009. The H1N1/A Swine Flu, other infectious diseases, and human-sourced emergencies and disasters have spurred tremendous interest in pre-event planning and preparedness. Yet ethical and perception of response are still being debated. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies and Co-Director of the UCSD San Diego Center for Patient Safety was asked to present his assessment of these issues.

Professor Liang, a physician and an attorney, noted that models of priority of treating patients during emergencies and disasters have not been well-founded nor have they involved community input. Further, legal challenges of organizing and allowing out-of-state providers to enter into emergency and disaster locales have created uncertainty as to the permitted scope of action. He called for a greater openness of models and approaches of allocated scarce resources in emergencies and disasters, and uniform rules for providers who participate in response.

Dr. Liang’s presentation was entitled, “Perceptions and Hindsight Post-Emergency and Disaster Response: A Cautionary Tale.” Professor Liang was invited to the conference by Mary Hilfiker, MD, PhD, Department of Pediatric Surgery, Rady Children's Hospital.

Professor Bryan Liang Comments on Pharmaceutical Pricing Case in KCBS Interview

December 10, 2009. In a closely watched case, the 9th Circuit Court of Appeals held for Santa Clara and Santa Cruz counties in a ruling that is expected to curb drug prices at public hospitals and community health centers. KCBS interviewed Professor Bryan Liang on the decision.

Professor Liang noted that the case is a watershed moment for challenging pharmaceutical prices under the federal “340B” program, which provides for discounted drugs for public clinics providing care to low income individuals. He observed that the case allowed individual counties to sue pharmaceutical manufacturers for violations of price agreements negotiated by the Secretary of Health and Human Services. Pharmaceutical companies had argued that counties as could not sue them, and only the Secretary had the power to attempt to enforce the contractual price agreement.

Professor Liang was interviewed by Matt Bigler, KCBS news reporter.

IHLS and HLS Representatives Appear in San Diego Blood Bank Public Service Commercial

December 8, 2009. IHLS Executive Director Bryan A. Liang, IHLS Program Administrator Pam Tait, HLS President Matt Wheeler, HLS VP Gina Dawson, HLS Treasurer Ben Kradin, and members of the California Western School of Law appeared in the San Diego Blood Bank Public Service commercial. The commercial is aired to encourage organizations and individuals to hold blood drives and give blood for community benefit.

“We are fortunate to have the San Diego Blood Bank in our community to save lives of thousands of patients each year,” said Professor Liang. “We ask members of our community to follow our lead and assist the San Diego Blood Bank and organizations such as IHLS, HLS, and California Western School of Law in helping needy San Diegans.”

IHLS and HLS are the highest status Life Level Four members of the San Diego Blood Bank.

Professor Bryan Liang Interviewed by KCBS on Senate Abortion Amendment

December 8, 2009. The intensifying debate on health care reform has begun. Recently, Sen. Ben Nelson introduced a bill prohibiting any use of federal funds for abortion in new reform options. KCBS interviewed Professor Bryan A. Liang on his perspective.

Professor Liang noted that Congress was permitted to limit what services any reform efforts would pay for. However, he also indicated that as restrictions become more of a barrier, women may be able to argue a violation of equal protection under the US Constitution.

Professor Liang was interviewed by Rebecca Corral and Melissa Culross, KCBS News Anchors.

Executive Director Bryan A. Liang Gives Pharmaceutical Pricing Presentation at UCSD Rady School of Business

December 4, 2009. IHLS Executive Director Professor Bryan A. Liang gave a presentation on pharmaceutical pricing and health care reform at the UCSD Rady School of Business. His presentation was entitled, “Pharmaceutical Pricing and Health Care Reform: Upward Spiral or Down the Drain?”.

“Although there are many economic models of value and pricing strategies, in the public policy domain, the key consideration is cost,” said Professor Liang. “Global budgets and short term outlook and justifications dominate the discussion. Despite corporate long term outlooks in the pharmaceutical industry, the reality the industry must face is that pricing must be sensitive to policy needs and it must adjust its efforts accordingly,” he added.

Dr. Liang also joined Ciara Kennedy, PhD, and Michael Pollack, VP of Health Economics at Biogen-Idec, for a panel assessment of pharmaceutical pricing strategies.

Dr. Liang was asked to present by Jay Kranzler, MD, of the Rady School of Business and CEO of Cypress Biosciences.

KCBS Interviews Professor Bryan Liang on COBRA Subsidies Program Termination

December 1, 2009. COBRA health insurance subsidies passed under the American Recovery and Reinvestment Act are scheduled to end this month. Nationally syndicated radio KCBS interviewed Professor Bryan Liang on the implications for the public.

Professor Liang noted that the program termination may have significant impact on access to health insurance. With the cost of family health insurance representing approximately 80% of national unemployment benefits each month, loss of the subsidy will require many if not most families to drop health care coverage. He indicated the weaknesses associated with “band aid” approaches such as the COBRA subsidies emphasize the need for substantive reform.

The story is "Laid Off Workers Face Expiration of Health Benefit." Professor Liang was interviewed by KCBS reporter Holly Quon.

Professor Bryan A. Liang Appears on UCSD Graduate Program Information Media

November 30, 2009. Executive Director Professor Bryan A. Liang, Shapiro Distinguished Professor of Health Law at California Western School of Law, as well as Associate Professor of Anesthesiology and Co-Director of the San Diego Center for Patient Safety at UCSD School of Medicine, appeared on video information media regarding UCSD Masters of Advanced Studies graduate school programs.

Professor Liang was interviewed about key aspects of the UCSD MAS program in Leadership in Health Care Organizations as well as the joint UCSD-CWSL MAS program in Health Law. He is the only faculty member in both programs and was the only person interviewed for both.

The information videos will be aired in various traditional television media as well as on the Internet.

Executive Director Professor Bryan Liang Quoted in Washington Post Article on Counterfeit Drugs

November 20, 2009. The challenges of counterfeit drug sales around the world have continued to attract law enforcement attention, with the most recent Operation Pangea II resulting in coordinated global arrests and seizures of hundreds of persons and products involved. The Washington Post interviewed Professor Bryan Liang about Pangea II.

Professor Liang, a noted expert on counterfeit drugs and the Vice President of the Partnership for Safe Medicines, indicated that the global trade in counterfeits was growing. He emphasized that coordinated and cooperative law enforcement efforts are key to address global health concerns represented by counterfeit drugs.

The story is "Crackdown targets counterfeit drugs: Raids held worldwide," by Ylan Q. Mui, in the November 20, 2009 edition of the Washington Post.

Daily Journal Interviews Professor Bryan Liang on Disability Insurance Story

November 20, 2009. Investigations of California Department of Insurance actions have prompted concerns about the extent consumers are protected against inappropriate denial of coverage by disability insurers. The Los Angeles Daily Journal interviewed Professor Bryan Liang on his perspective.

Professor Liang noted that CDI and other state agencies have an obligation to protect the public against suspect insurer actions if they occur to citizens of the state. He called for an independent assessment of CDI actions to determine if they have met their mandate of consumer protection.

The story is "Disabled Turn to State for Help, But State Turns Them Away," by Evan George in the November 20, 2009 edition of the Los Angeles Daily Journal.

San Diego Union Tribune Publishes Health Reform Opinion Editorial by Professor Bryan Liang

November 19, 2009. The respect for patients and improved provider communication is essential for patient safety. Yet these concepts have not been considered in the current health reform debate. Professor Bryan Liang published an opinion editorial in the San Diego Union Tribune on this topic.

He pointed to the poor patient experience scores of virtually all hospitals in the US as measured by the federal government. Dr. Liang called for mandated use of patient experience scores for inclusion in any federal health care program under health care reform, and minimum grade levels for reimbursement purposes. He concluded by noting that patient respect is also a matter of patient safety, and that both must be emphasized by any tenable lasting reform efforts.

The opinion editorial is "Report cards key to health reform," in the November 19, 2009 issue of the San Diego Union Tribune.

International Society of Pharmaceutical Engineers Annual Meeting Features Professor Bryan Liang

November 10, 2009. The International Society of Pharmaceutical Engineers held its Annual Meeting, "Thriving in a Survival Environment" in San Diego, CA. Of great interest to this group is anti-counterfeiting science, engineering, and policy. Because of his expertise crossing all of these disciplines, ISPE asked Professor Bryan Liang to share his thoughts on the state of technology and policy issues in anti-counterfeiting and the pharmaceutical industry.

Dr. Liang noted that means and methods such as RFID (radio-frequency ID tags), near-IR spectroscopy, and other efforts were important in advancing process application technology efforts. However, he noted that point of care testing, field assessment, and supply chain issues cannot be solved through technology alone. He called on engineers to work with their company's regulatory side as well as law enforcement to strategize on the role of technology in combination with supply chain realities in anti-counterfeting efforts.

Dr. Liang was invited to ISPE 2009 by Dr. Sharon Flank, CEO of InfoTrak. Their session was "Anti-Counterfeiting: Can Chemistry Trump Bureaucracy?".

Professor Bryan A. Liang Discusses Law and Medicine Issues at UCSD School of Medicine

November 10, 2009. The increasing influence and interaction between the legal system and medical practice are of great interest to physicians in training. Professor Bryan A. Liang provided an overview and discussed these issues with UCSD School of Medicine Class of 2011 students.

"Law in medicine is not only about medical malpractice anymore," said Professor Liang, who is both a physician and attorney. "Virtually all aspects of care are influenced by law--standards of care, financial incentives,end of life, and insurer activities. We need to understand these issues in order to be effective advocates for our patients."

Dr. Liang was an invited lecturer to the Introduction to Health Care Systems program at UCSD School of Medicine. He was invited by Professor Rick Kronick, UCSD Professor of Preventive and Family Medicine.

Drug Topics Features Comments on Health Care Reform and Importation by Bryan A. Liang

November 3, 2009. With the health care reform bills drafted and debate heating up, the impact on the drug supply is dominating discussions at all levels. One key area is the costs of drugs, and policies to address it such as importation. Drug Topics featured comments by Executive Director Bryan A. Liang on the issue.

Dr. Liang noted that importation is not a "safe" alternative, since the countries being contemplated have had significant issues with counterfeit and diverted drugs. He also notes that the American Pharmacists Association has opposed drug importation unless the Secretary of Health and Human Services can ensure safety, as required by law. Finally, Dr. Liang observed that failure of the importation policy will fall on the most vulnerable of patients, and called on pharmacists to discuss the issue with their elected representatives.

The story is "Healthcare Reform: Readers Speak Out," and is the cover story of the November 2009 edition of Drug Topics.

Executive Director Bryan A. Liang Gives Patient Safety and Transparency Lecture at UCSD

November 3, 2009. Key concerns about patient safety include systems issues and quality. But transparency is a fundamentally important basis as well. Professor Bryan Liang outlined these themes in a lecture to UCSD School of Medicine students.

Dr. Liang outlined the systems nature of health care, providing information about the theory of complex systems. But he then noted that any effort to improve system function, as well as serve the needs of the patient, requires transparency to identify vulnerabilities, keep communication lines open, and ensure patients are provided with ethically-mandated disclosure when error and injury occur.

Professor Liang was asked to speak by Rusty Kallenberg, MD, UCSD School of Medicine.

Professor Bryan A. Liang Gives Global Health and Pharmaceutical Issues Presentation

November 2, 2009. The challenges of ensuring drug safety is global. These issues affect regulatory structures and processes. Professor Bryan Liang was asked to present his perspective on the means to address these concerns arising from this intereaction.

Professor Liang first noted that geopolitical boundaries are the basis for regulatory rules, yet drug supply issues are global and globalized. Hence, already the foundation for ensuring drug supply safety is weak. He then outlined the difficulties with parallel trade, counterfeit drugs, and their impact on vulnerable patients who shoulder the risk of policy failure. He also pointed to the geopolitical risks of allowing the vast majority of drugs to be made outside the USA. He called for robust regulatory harmonization and international diplomacy efforts to begin to address these concerns.

Professor Liang's presentation was entitled, "Globalization of the Drug Supply: Counterfeit Drugs and Biopreparedness Challenges," in the Global Health I UCSD-SDSU Program on Global Health. Dr. Liang was asked to present by Professor Tom Novotny, Director of the Global Health Program.

KGTV-ABC !0 News Interviews Professor Bryan A. Liang on Counterfeit Tamiflu

October 30, 2009. With increasing reports on the extensive nature of H1N1/A (Swine) Flu infections, patients are seeking anti-viral Tamiflu anywhere they can get it, including over the border in Mexico. However, there may be risks in doing so. KGTV-ABC 10 News interviewed Professor Bryan A. Liang on the topic.

Professor Liang noted that Tamiflu purchased over the border and on the Internet is likely to be fake. He indicated that much of the Tamiflu supply is under the control of the Mexican federal government, and Tamiflu now represents the most spanned drug in email solicitations. He cautioned patients to avoid these high risk sources and stick with local pharmacies.

Professor Liang was interviewed by Michael Chen, KGTV reporter.

WFRU Interviews Professor Bryan A. Liang on Public Option Proposal

October 23, 2009. With the public option becoming more of a viable concept in Washington, questions are being raised about its viability. WFRU in Columbia, MO asked Professor Bryan Liang about his assessment of this alternative.

Professor Liang noted that Missouri has quietly established its own public option system, growing the program from a state employee program and extending it to local governments, in combination with a state based program that allows small business employees to maintain insurance, which has helped increase insurance coverage. This state-based approach may be a model for US efforts.

Dr. Liang was interviewed by Davild Lile on the WFRU Morning Show, WFRU.

84WHAS Discusses Health Care Reform Options with Professor Bryan A. Liang

October 21, 2009. The options being floated in Congress for healthcare reform are numerous. Yet insurance access may not solve the healthcare problems for many Americans. 84WHAS in Lousiville, KY asked Professor Bryan Liang for his thoughts.

Professor Liang noted that insurance access is not the same as healthcare access, and that insurers who have limited competition under current antitrust exemptions may simply deny care to reduce costs. He advocated for removing antitrust exemptions increase competition and permitting insurers to compete across state lines. He also indicated that a Medicare basic benefits package for all, with competition on any additional healthcare services and products beyond that basic benefits package would ensure adequate access to services while allowing competition to provide a greater range of options for those who want additional services.

Dr. Liang was interviewed by Francene Cucinello, host of The Francene Show, WHAS News.

IHLS Participates in Kids' News Day for Benefit of Rady Children's Hospital

October 20, 2009. The Institute of Health Law Studies was ready to hit the streets before the ink had time to dry on the daily San Diego Union Tribune. IHLS picked up 200 papers at the local distribution center for the 20th Annual Kids’ News Day and set out before sunlight to sell them on the corners of 3rd and Cedar Street downtown.

With the assistance of several law students from California Western School of Law, Pam Tait, IHLS Program Administrator stood with bundles of freshly printed papers on the street and began selling the papers for $1 each and any additional donation. Today’s paper was a special edition of the Union Tribune that featured the advances being made and lives being changed at Rady Children’s Hospital in San Diego.

IHLS was able to raise funds to promote better healthcare for the San Diego community, including the 143,000 children in need. In addition, the effort brought awareness to the public that local efforts can make a difference in someone’s life through even a small donation.

CKTB Canada Discusses Health Care Reform with Executive Director Bryan A. Liang

October 20, 2009. Health insurance reform has attracted attention across the border in Canada. Canadians are interested in determining the chances for substantive reform in the US because of the potential impact on services within their borders. CKTB in St. Catherine’s, Ontario interviewed Professor Bryan Liang, who has worked in Canada on US-Canada health issues, for his assessment.

Professor Liang noted the key issue is insurer regulation and how it may affect denials of care requests by patients. He indicated that without attention to denials, and other barriers such as increased pre-authorization requirements for expensive disease treatment, even more patients may be left without access under health care reform.

Professor Liang was interviewed on CKTB News Hour by Stephanie Sabourin.

KMJ News Interviews Professor Bryan Liang on Health Care Reform and Patient Access

October 20, 2009. Health care reform efforts have been promoted as increasing access to all citizens. Yet there may be weaknesses. Professor Bryan Liang was interviewed by KMJ Fresno on his perspective.

Professor Liang noted that with limited ability of insurers to “cherry pick” the healthiest patients, they will turn to their other major tool to reduce costs—simple denial of care. He called for a rigorous regulatory structure to ensure standard systems of accountability for these insurers as well as the government if they enter into health care provision.

Professor Liang was interviewed by Ray Appleton on the Ray Appleton Show, KMJ Fresno, CA.

San Diego Business Journal Quotes Professor Bryan A. Liang on Healthcare Reform Concerns

October 19, 2009. The challenges on the local and national levels with respect to health care reform have brought great concerns to health care business leaders. The San Diego Business Journal interviewed Professor Bryan Liang on the issues and an assessment of what may happen in the ensuing negotiations.

Professsor Liang noted that much of the business focus is upon stakeholder financial benefits and losses, despite rhetoric to the contrary. He also added that costs will rise but challenges to greater public involvement in health care are hollow since much of the health care delivered in the US is through government programs already.

The story is "Providers Fear Costs of Medical Reform Could Outweigh Benefits" by Marion Webb in the October 19, 2009 issue of the San Diego Business Journal.

KCBS Radio Interviews Professor Bryan A. Liang on Access to Care Issues in Health Care Reform

October 19, 2009. Challenges on the national and local level with respect to health care reform are heating up as debate continues. KCBS San Francisco interviewed Professor Bryan Liang on these issues.

Professor Liang noted that without attention to private health care incentives to deny care or create barriers to re-enrollment of patients into plans, health care access by sick would be stymied. As well, he pointed to the current controversy in San Francisco with one group of providers being terminated by an HMO associated with UCSF due to financial concerns, putting patient access to care at risk.

Professor Liang was interviewed on KCBS News in San Francisco, CA.

Bryan A. Liang and Judith McCarter Publish Perspectives Pieces on Fraud and Abuse Compliance

October 19, 2009. Fraud and abuse costs hundreds of billions of dollars to the health care system each year. Yet the lack of standardization of regulator expectations makes compliance difficult. IHLS Executive Director Professor Bryan A. Liang and IHLS Research Associate Judith McCarter published a Perspectives piece in the Los Angeles Daily Journal that proposes reform in this critical area.

Dr. Liang and Ms. McCarter indicate that there is a business case for ethical business practice in the health care arena, including implementation of fraud and abuse compliance programs. They propose a standardized structure based on previous government model compliance programs for all health care business, and additional unique characteristics for each health care sector. In exchange for such implementation, government authorities would presume compliance with these laws. They would also make stimulus funds available for electronic internal audit implementation.

The piece is entitled "Cooperative Compliance: Healthcare Fraud and Abuse, in the October 19, 2009 issue of the Los Angeles Daily Journal on page 5.

KIRO Seattle Discusses Health Care Reform with IHLS Executive Director Bryan A. Liang

October 19, 2009. Health care reform advocates are questioning current health reform efforts. KIRO Radio in Seattle interviewed Professor Bryan Liang on his perspective.

Professor Liang noted that federal law, the Employee Retirement Income Security Act, insulates insurers from denial of care damages claims of patients, and that reform proposals do not address insurer denials, increases in pre-authorization requirements for sick patients, or increases in premiums. He called for strict regulation of private insurers or a single payer structure to ensure adequate coverage for patients when they need care.

Professor Liang was interviewed by Dave Ross on the Dave Ross Show, KIRO Radio, Seattle, WA.

Los Angeles Times Interviews Professor Bryan A. Liang on Adequacy of Healthcare Reform Efforts

October 19, 2009. Health care reform efforts continue apace. Yet questions still remain as to whether they are enough. The Los Angeles Times interviewed Professor Bryan Liang on his perspective.

Professor Liang noted that under current health care reform efforts, the system is still stacked against the patient. He noted that the strong role of private insurers will continue to allow incentives to deny care and create barriers for patients to receive it. He called for substantive reform that strongly regulates when care can be denied and how much insurers may charge sick patients.

The story is "Healthcare bills lack protections against treatment denials, experts say" by Lisa Girion in the October 19, 2009 edition of the Los Angeles Times.

San Francisco Daily Journal Quotes Professor Bryan A. Liang on Disability Insurer Story

October 13, 2009. Disability insurers have engaged in significant abuses in denying claims. An investigative report on these practices show tremendous challenges for beneficiaries to obtain benefits due to federal law. The San Francisco Daily Journal interviewed Professor Bryan Liang on the issue.

Professor Liang noted that insurers have little if any incentive to grant disability benefits even in the face of independent physician and Social Security Administration agreement the person is disabled. Review of insurer decisions under federal law have a low “abuse of discretion” standard. He called for an independent review assignment system that does not reward external reviewers for denying claims through repeat business.

The story is "Doctors Paid To Aid Insurers In Disability Claim Denials," by Evan George of the San Francisco Daily Journal. This story is Part II of the special investigative report on disability insurer practices.

Professor Bryan A. Liang Joins Editorial Board of Drug Topics

October 9, 2009. Professor Bryan A. Liang has joined the Editorial Board of Drug Topics. Drug Topics is a monthly publication that covers professional drug topics and policy for the pharmacy and pharmaceutical professional communities.

"This appointment is a great honor and opportunity," said Professor Liang on the announcement. "Drug Topics addresses issues on the cutting edge of the pharmaceutical and pharmacy world, and has tremendous impact in policy discussions in the US."

Dr. Liang was invited to the board by Margaret Mulligan, Editor-in-Chief of Drug Topics.

IHLS and HLS Reaches San Diego Blood Bank Life Level Four Member with Most Recent Blood Drive

October 8, 2009. The Institute of Health Law Studies and Health Law Society held its fourth blood drive of the year, with 29 successful donations for the event. With this most recent effort, IHLS and HLS reached the pinnacle group level possible for blood donations, the Life Level Four Member. LIfe Level Four Members exemplify the highest level commitment to community service and play a pivotal role in ensuring that our community has a plentiful blood supply available for patients in need.

"Many committed people provide blood for the benefit of patients," said Dr. Bryan Liang, Executive Director of the Institute of Health Law Studies, and a former blood bank director. "But to reach this highest level of community service is truly a great accomplishment. IHLS, HLS, and the CWSL community of faculty, staff, and students should be proud to be part of this elite group."

Congressional Quarterly Researcher Story on Prescription Drug Abuse Features Comments by Professor Bryan A. Liang

October 8, 2009. The revelations of prescription drug abuse highlighted by celebrity deaths has promoted investigations by a wide array of policymakers. CQ Researcher in its focus research article on this topic featured comments by Professor Bryan Liang.

Professor Liang directed his comments on the scope of prescription drug abuse compared with illicit drugs. He also noted that there is tremendous unregulated demand through the Internet, and pointed to the challenges of legal responses to the problem. Finally, he noted that prescription drug abuse is growing alarmingly in the youth population, and that policymakers must act to prevent "young addicts, since young addicts become adult addicts."

The article is "Medication Abuse: Is tighter regulation of prescription drugs needed?," by Marcia Clemmett in the October 9, 2009 issue of CQ Researcher.

Los Angeles Times Interviews Professor Bryan Liang on Transplantation Coverage Article

October 7, 2009. Challenges to denial of insurance claims such as transplantation have raised important policy issues for health care reform advocates. The recent case filed against Blue Cross California for denying such a claim for a patient who choose to relocate to Indiana for an improved chance at getting an organ has highlighted these concerns. The Los Angeles Times interviewed Professor Bryan Liang on the issue.

Professor Liang noted that insurers choose particular groups and physicians to review these claims, often, as in this case, without transplantation backgrounds or experience. He added patients have little knowledge of how the system works, and so are often powerless to challenge these denials. He called for reform in this area based on required expertise to review challenged health insurer denials.

The story is "Patient sues Anthem Blue Cross over liver transplant" by Lisa Girion in the October 7, 2009 issue of the Los Angeles Times.

IHLS Participates in 3rd Annual Rady Children's Hospital Shamu and You Family Walk

October 3, 2009. The Institute of Health Law Studies, led by Program Administrator Pam Tait, once again participated in the Rady Children's Hospital Annual Shamu and You Family Walk. The IHLS "Whale Walkers" team raised almost $700 to help sick children in the San Diego community.

The IHLS team was one of the 157 that walked for the event. There were over 137 volunteers and together the Family Walk raised over $250,000. All proceeds will help support the life-saving efforts at Rady Children’s Hospital in San Diego. IHLS has supported the Shamu and You Family Walk each year through team participation and volunteer efforts.

Executive Director Professor Bryan A. Liang Gives Emergency Public Health Powers Presentation

October 1, 2009. The challenges of pandemic flu, bioterrorism, and other public health emergencies require an attention to public health powers in disaster and emergency preparedness. Professor Bryan Liang gave a presentation in the seminar series, “Legal Lessons of Katrina & Other Natural Disasters.”

“Key to understanding public health legal powers in emergencies and disasters are the 5D’s: in these circumstances, public health providers have the power to “do [things to] and detain” individuals, “direct” professional activities, “determine” the use of private property, and “disclose” private healthcare information,” Dr. Liang explained. “These powers are critical in ensuring that an adequate response to unforeseen public health issues can occur.”

Professor Liang was asked by Professor Ken Klein of California Western School of Law to provide present on this topic for the series.

San Francisco Daily Journal Article on Pharmaceutical Executive Conviction Quotes Professor Bryan Liang

September 30, 2009. The closely watched trial of Scott Harkonen, the ex-CEO of InterMune, who was accused of wire fraud by federal authorities for statements made promoting unapproved uses of its product in press releases, resulted in a guilty verdict. The San Francisco Daily Journal asked Professor Bryan A. Liang to comment.

"This is a huge win for the Department of Justice, which has been trying to reign in illegal off-label claims for drugs by pharmaceutical companies," said Dr. Liang. "Beyond already fining the company $37 million, personal liability against executives should send a strong message that drug company officers cannot assume they are safe even if the company pays out millions in penalties," he added.

The story is "Biopharm exec is convicted," by Rebecca Beyer in the September 30, 2009 issue of the San Francisco Daily Journal.

Executive Director Professor Bryan A. Liang Quoted on KPBS Story on California Gender Rating Bill

September 29, 2009. As federal health care reform stalls, individual states are moving forward with their own efforts. The California Legislature has passed a gender rating bill and sent it to the Governor. The bill would prohibit individual health insurance plans from discriminating against women by charging them higher premiums. KPBS asked Professor Bryan A. Liang to comment.

"This approach of gender neutrality in health insurance premiums is not something new or unusual, since at least 10 other states have similar provisions," observed Professor Liang. "With health care reform wrangling and lack of progress on the federal level, it is important for states to lead the effort," added Professor Liang.

The story is "Two Bills Could Change California's Individual Insurance Market", KPBS. Professor Liang was interviewed by KPBS Health Reporter Kenny Goldberg.

IHLS Joins the Rady Children’s Hospital Miracle Makers Celebration at Humphrey’s by the Bay

September 23, 2009. IHLS was honored as part of the Miracle Maker at the Rady Children's Hospital Miracle Makers Celebration at Humphrey's by the Bay. The event celebrated all the outstanding fund raisers for the children in San Diego.

Through its many hours of fund raising and volunteering, IHLS reached the status as a Miracle Maker with Rady Children’s Hospital. As a Miracle Maker, IHLS enhances hospital morale, increases corporate and community awareness and enriches the lives of sick children. IHLS has built a healthy partnership for CWSL and Rady Children’s Hospital through its commitment to community service for this critical patient population.

Nature Biotechnology Interviews IHLS Executive Director Bryan A. Liang on Biotech Drug Safety

September 21, 2009. New evidence suggests that safety issues are heightened with complex drugs known as biologics. Nature Biotechnology, the leading worldwide biotechnology academic journal, interviewed IHLS Executive Director Bryan Liang on these findings.

Professor Liang noted that it was unsurprising that biologic drugs have greater risks due to their size and complexity. Dr. Liang also observed that the use of living organisms also contributes to the potential for adverse effects, and pointed to the Epogen case that resulted in patients not only being allergic to the drug, but also the resultant patient immune reactions to their own natural form. These findings point to the need for significant safety studies for any future new or "biosimilar" form of biotech drugs.

The story is "JAMA study casts cloud over biologic safety" by Jim Kling, in volume 27, pages 11-12 of Nature Biotechnology.

IHLS Provides Assistance to the Steve Open 6th Annual Tower Glass Golf Tournament

September 12, 2009. As the San Diego temperatures reached the 3-digit numbers, IHLS was out on the Steel Canyon Golf Course in Jamul to support the Rady Children's Hospital. At this community service event, there were 144 players in a four man scramble format that bore the heat as IHLS provided them liquids to keep hydrated and found them shade as they waited for their teams to tee off. At its peak, the heat reached 103 degrees but IHLS managed to keep the players hydrated and moving along the course.

All proceeds from the tournament went to assist children in the San Diego community through the Rady Children’s Hospital Foundation. IHLS participates regularly in supporting the Rady Children's Hospital activities and service events.

WBAL Radio Interviews Professor Bryan Liang on Novel H1N1/A Swine Flu Issues in Schools

September 1, 2009. With the upcoming school year beginning, schools concerned with the novel H1N1/A (Swine) Flu transmission have adopted policies, including a “no touch” policy for students in an effort to prevent transmission. WBAL interviewed Professor Bryan Liang on his thoughts on this strategy.

Dr. Liang noted that the "no touch" policy was a tenuous idea at best, and asking students not to touch each other will not be an effective approach to limit infections. He also indicated that since the virus stays infectious for 2-8 hours on inanimate surfaces, a robust system of cleaning as well as traditional flu hygiene would be a better approach.

Dr. Liang was interviewed on the Shari Elliker Show, WBAL in Baltimore.

IHLS Partners with Rady Children’s Hospital in Cancer Care Center Fundraiser

August 20, 2009. In another community service project with Rady Chldren's Hospital, IHLS partnered with the Cancer Care Center to support the 6th Annual Dale Donnelly Memorial Golf Tournament. As part of this effort, IHLS representatives, including Program Administrator Pam Tait, managed the administrative process of checking in more than 100 golf participants arrived at The Riverwalk Golf Club, coordinated team foursomes for photos, and matched them up to their labeled course transport. It was a beautiful summer day in San Diego for all that attended.

IHLS Executive Director Bryan A. Liang noted that "this is the kind of community partnership IHLS is so very fortunate to have the opportunity to participate in." Dr. Liang also added that "our presence and particularly the leadership of Pam Tait has really allowed us to give back to those worthy patients and families who are courageously facing some of the most complex diseases and challenges to their health."

This was the 6th Annual Dale Donnelly Memorial Golf Tournament held by Rady's. The tournament helps to “restore, sustain and enhance the health and development potential of children” here in San Diego. Past tournaments have raised over $60,000 for this worthy cause. IHLS has worked with Rady Children's hospitals on numerous community events, including its Valentine Day Party for children and their families, and Pam Tait and Executive Director Bryan A. Liang serve on Rady's Auxilliary Board.

Bankrate.com Article on Student Health Insurance Quotes Professor Bryan A. Liang

August 20, 2009. As students go back to school, parents are faced with increasing costs. One area, student health insurance coverage, is a growing issue after a GAO report indicated many school-based plans are limited. Bankrate.com interviewed Professor Bryan Liang on the topic.

Professor Liang indicated that many school programs have extremely limited coverage and have internal caps on services. He noted that the best solution for the vast majority of students is to keep their parents plan if possible. He called for colleges and universities to allow students to use their families' health insurance for the benefit of students, their families, and the schools themselves.

The story is "Campus health insurance or family plan?" by Melissa Ezarik, and was posted online at Bankrate.com on August 20, 2009. Professor Liang is also author of the report, "Crisis on Campus: Student Access to Health Care," forthcoming in the University of Michigan Journal on Law Reform. This report has been a Top Ten Downloaded paper (see "Professor Bryan A. Liang's Paper on College Health a Top Ten Downloaded Paper in Multiple Categories," a July 9, 2009 Institute Healthliner).

National Committee on the Prevention of Elder Abuse Appoints Professor Bryan Liang to Research Proposal Review Committee

August 14, 2009. The National Committee for the Prevention of Elder Abuse appointed Professor Bryan Liang, Executive Director of the Institute of Health Law Studies to its Research Proposal Review Committee. This committee is empowered to choose ten elder justice coalitions across the United States for funding.

"This is a wonderful opportunity to promote the goals of the NCPEA, including a broader role for elder justice coalitions," said Dr. Liang. "This function is an important part of the effort of the US Administration on Aging to address the key problem of elder abuse in the US."

Dr. Liang was invited to serve on the committee by Professor Pam Teaster, President of the NCPEA.

Executive Director Bryan A. Liang Quoted in Story on Governor's Line Item Vetoes

August 13, 2009. The budget woes of California continue despite an apparent agreement. Senate Pro Tem Darrell Steinberg filed suit against Governor Schwartzenegger after the Governor used the line item veto to cut $400 million from the recently agreed on budget. The Los Angeles Daily Journal interviewed Professor Bryan Liang on his reaction.

Professor Liang indicated that the key would be the definition of “appropriations” to ascertain the legality of the Governor’s efforts. However, he observed that this would likely cost taxpayers more money, and both sides should have addressed these issues before a final budget was sent to the Governor’s office.

The story is "Health Care Providers Pile on Budget Lawsuits Against Governor" by Evan George, in the August 13, 2009 edition of the Los Angles Daily Journal.

San Francisco Daily Journal Article on Pharmaceutical Executive Trial Quotes Professor Bryan A. Liang

August 11, 2009. With federal prosecutors gearing up for a criminal trial against a Dr. Scott Harkonen, a former drug company executive charged with fraudulent off-label promotion, the San Francisco Daily Journal interviewed Professor Bryan Liang on the case.

Professor Liang noted that there were specific laws prohibiting off label promotion, and there are clear lines about what can and can’t be said in communications regarding drug use in promotion. He also observed that criminal cases in this area are rare, and only egregious examples are those that are prosecuted.

The story is "Off-Label Drug Marketer Heads to Trial: Pursuit of Individual Criminal Charges is Unusual, Attorneys Say, and Raises Questions," by Rebecca Beyer, in the August 11, 2009 edition of the San Francisco Daily Journal.

Professor Bryan A. Liang Publishes San Diego Union Tribune Opinion Editorial on Insurance Regulations

August 9, 2009. The issue of health insurance rescission has garnered state and national attention. Recently, the California Department of Insurance announced new proposed regulations to address the issue.

However, Professor Bryan Liang notes in an opinion editorial in the San Diego Union Tribune that the law is already established, and no new regulations are needed. Instead, he called for more resources for aggressive enforcement action against offending insurers. He also called for an independent panel to review potential rescissions before they occur.

The opinion editorial is "Curing insurance ills: We need fewer words and more enforcement action," in the August 9, 2009 edition of the San Diego Union Tribune, on page B5.

Research Associate Tim Mackey and Executive Director Bryan A. Liang Publish Op Ed in San Francisco Daily Journal on Climate Change Technology Transfer

August 7, 2009. With Congressional proposals on the environment and the UN Climate Change conference looming, the issue of climate change and global mitigation of its impact has become increasingly important in international policy. Tim Mackey, IHLS Research Associate, and Professor Bryan Liang,IHLS Executive Director, in an opinion editorial in the San Francisco Daily Journal argue that more needs to be done to provide developing countries with “green” technology to assist in their economic development while simultaneously protecting the environment. Use of a “messenger model” and discounted climate change technology transfer can accomplish these goals while also providing flexibility for both the public and private sectors.

The opinion editorial is "The Green Light" in the August 7, 2009 issue of the San Francisco Daily Journal, page 6.

Executive Director Bryan A. Liang Interviewed by National Public Radio on Michael Jackson Story

August 4, 2009. The increasing revelations of Dr. Conrad Murray have made headlines as each day passes without a confirmed cause of death of Michael Jackson. Dr. Murray is the physician that was with Michael Jackson when he died and is the reported source of the controversial drug propofol that Jackson took for sleeping. NPR interviewed Professor Bryan Liang on the medical-legal implications of the investigation.

Dr. Liang noted that the drug Dr. Murray was using is generally not used outside the operating room, and never in the home setting. As well, procuring drugs for Michael Jackson that were not medically indicated could place the physician in circumstances that allow for an involuntary manslaughter charge to be brought against him beyond civil lawsuits for malpractice.

Dr. Liang was interviewed by Robin Young, host of the NPR "Here and Now" program.

IHLS Reaches “Group Difference Life Level Three Member” Status with San Diego Blood Bank

July 30, 2009. Due to the third successful blood drive held on July 14, 2009, IHLS was recognized by the San Diego Blood Bank as a “Life Level Three Member.” This is a community service title provided to local San Diego groups that set out each year with a projected goal and have reached selected milestones in program support and outcomes. IHLS collaborates with its student organization, the Health Law Society each quarter to conduct an on campus blood drive.

Dr. Bryan A. Liang, Executive Director of IHLS, noted that “this community service recognition by the San Diego Blood Bank is a wonderful indication that our programs are on track and are benefiting San Diego patients.” He added that “as a former blood bank director, these partnerships in the community provide a significant benefit for patients because of the limited supply and constant need for these gifts of life.”

The highest level in the system is a Life Level Four Member Status, which IHLS will be seeking at its next blood drive on October 8, 2009.

WBAL Interviews Professor Bryan Liang on Swine Flu and Vaccination Programs

July 29, 2009. The H1N1/Influeza A Swine Flu has recently been reported by the CDC to have caused one million infections and 300 deaths in the US this year. As the fall seasonal flu season comes closer, the development of vaccines and programs to address it have been discussed by the CDC. WBAL in Baltimore interviewed Professor Bryan Liang on the progress of public health efforts.

Professor Liang noted that by August, the H1N1/A vaccine would be in testing and the planned roll out will be likely in October. He added that challenges as to getting people to get the vaccine and public health surveillance will test our systems, and will bear close monitoring to ensure effectiveness. He urged listeners to obtain both the regular flu shot as well as the Swine Flu vaccine.

Professor Liang was interviewed by Shari Elliker of WBAL. Dr. Liang has been a regular contributor to a wide array of media on public health issues, including the Swine Flu.

Los Angeles Times Story on Michael Jackson Death Quotes Professor Bryan Liang

July 20, 2009. Revelations about Michael Jackson's death, including the potential role a physician prescribing powerful anesthetics could have played, have made headlines around the world. Hence, the accountability of medical providers in celebrity cases has become more prominent in the case. The Los Angeles Times interviewed Professor Bryan A. Liang on the issue.

Professor Liang indicated that the process in the Jackson case, like Anna-Nicole Smith, may take years because of the required investigations and toxicology tests that must be associated with law enforcement activities. He also noted that generally, medical care providers are held accountable using the civil system rather than the criminal system, and state medical boards could sanction, censure, and revoke licenses of those involved if they find wrongdoing.

The story is "Murder charges in Michael Jackson case are unlikely, source says," by Jack Leonard and Harriet Ryan in the Sunday, July 19, 2009 edition of the Los Angeles Times.

IHLS and HLS Hold Blood Drive for San Diego Blood Bank

July 14, 2009. The Institute of Health Law Studies and the Health Law Society of California Western School of Law held a blood drive to assist the San Diego Blood Bank in its efforts to ensure patient access to life-saving blood and blood products. The Drive's goal was 22 units, and the IHLS/HLS efforts resulted in an even greater collection, with a total of 24 units collected.

"Once again, IHLS and HLS were able to assist in this key community effort," noted IHLS Executive Director Professor Bryan A. Liang. "The need for blood is constant, and there are always shortages. By continuing our commitment to service, we are able to contribute to ensuring the most needy have access to this life-saving and life-sustaining resource."

IHLS and HLS are strong supporters of the San Diego Blood Bank, holding several blood drives each year. Institute Program Administrator Pam Tait coordinates these efforts, and has led the collection activities for the last several years.

Professor Bryan A. Liang's Paper on College Health a Top Ten Downloaded Paper in Multiple Categories

July 9, 2009. Professor Bryan A. Liang's paper, "Crisis on Campus: Student Access to Health Care," forthcoming in the University of Michigan Journal on Law Reform, was a Top Ten Downloaded Paper in DSHE: Consumer Behavior; Insurance & Financing in Health Economics; MCM: Other Regulation-Consumer Markets; and Education Law: College & Graduate Education, in the Social Science Research Network/Economic Research Network. The Social Science Research Network and Economic Research Network represent the largest source of social science and legal scholarship on the Internet, representing hundreds of thousands of academic papers, both published and unpublished.

"It is extremely gratifying to see our work garnering the attention of the academic community," said Professor Liang. "The community of scholars that can benefit from our research helps us promote our mission to do relevant and important work that assists in informed policymaking."

This is not the first time Professor Liang has been the author of a Top Ten Downloaded Paper. Several other articles he has written have also been in this elite category.

IHLS 5th Annual Erizen Sei Bowles Feed A Friend Food Drive Begins

July 1, 2009. There are over 16,000 homeless men, women and children throughout San Diego County. During the summer months, the Alpha Project’s food bank is very low and they are in need of non-perishable food items. Starting July 1st and throughout the month of July, IHLS will be collecting food items to help replenish the food bank for our homeless community here in San Diego.

Institute Executive Director Professor Bryan A. Liang stated that "Our students here at CWSL take an active role in assisting with the food donations and they really help make a difference in our local community. This is an annual event and this will be our fifth year assisting in this key community effort."

The Erizen Sei Bowles Feed A Friend Food Drive is named after Erizen Sei Bowles, a former CWSL student and IHLS President, who lost his life in an accident three years ago. He had a special interest in the plight of the homeless. The Food Drive is coordinated by Pam Tait, Program Administrator of IHLS.

Federal Trade Commission Study on "Authorized Generics" Features Research by Professor Bryan A. Liang

June 25, 2009. The Federal Trade Commission recently issued a long awaited report on "authorized generic" drugs. These drugs are brand name-sponsored forms that may have anticompetitive effects on generic drug entry. In this report, the Federal Trade Commission featured research by Professor Aidan Holiis of the University of Calgary and IHLS Executive Director and Professor Bryan A. Liang. The FTC found that its analysis agreed with Professors Hollis and Liang's.

"It is quite gratifying that our work was found to be useful by the FTC," said Professor Liang. "The challenge of access to drugs is a key policy issue and of great interest to the Obama administration, and we are of course quite happy that the FTC came to the conclusions we did in our analysis."

The report is entitled, "Authorized Generics: An Interim Report by the Federal Trade Commission," June 2009. The study on which the FTC relied is Aidan Hollis & Bryan A. Liang, An Assessment of the Effect of Authorized Generics on Consumer Prices, Arlington, VA: Generic Pharmaceutical Association (2006) (reprinted as: Aidan Hollis & Bryan A. Liang, An Assessment of the Effect of Authorized Generics on Consumer Prices, 10(1) Journal of Biolaw & Business 10-18 (2007)).

IHLS Executive Director Professor Bryan A. Liang and Member Arlene Luu Give Elder Abuse Presentations at Southwestern School of Nursing

June 24, 2009. Executive Director Professor Bryan A. Liang and IHLS Member Arlene Luu gave elder abuse presentations at the Southwestern School of Nursing in Otay Mesa, CA. Professor Liang’s presentation was entitled, “Elder Abuse, Reporting, and Recognition: Using Patient Safety Principles in the Protection of the Vulnerable Patient,” and Ms. Luu’s presentation was entitled, “Assessing, Understanding, and Reporting Elder and Dependent Adult Abuse.”

Professor Liang noted that “there are no perfectly consistent signs and symptoms of elder abuse. But as providers, we can use our skills to identify clues that allow us to conclude whether there is reasonable suspicion of elder abuse.” He added that “it is not only our legal obligation to report elder abuse, it is also our ethical duty as healthcare providers with the privilege of treating patients.”

Ms. Luu added that “there are a lot of practical ways of determining when and how someone should report abuse. Each situation has to be evaluated individually, but no one can prevent you from reporting it.” Ms. Luu provided an extensive array of examples of abuse from recent and local newspaper accounts, and statistics on the prevalence of elder abuse.

Professor Liang and Ms. Luu have published extensively on the topic of elder abuse, and have given several training sessions on this topic. In addition, their educational presentations fulfill mandatory training requirements in this area.

Professor Bryan A. Liang Gives Plenary Presentation on the Future of Healthcare at Leadership Forum

June 23, 2009. Dr. Bryan A. Liang, Executive Director and E. Donald Shapiro Distinguished Professor at the Institute of Health Law Studies, gave a featured plenary presentation at the University of California San Diego Health Sciences Leadership Forum. His presentation was entitled, "Facing the Future: Healthcare Survival in an Uncertain Delivery Climate."

As indicated by Professor Liang, "we need to get the steps right in the business of healthcare. Providing the right care, to the right patient, at the right time most efficiently is the second step. The first step is getting the business." Professor Liang then outlined the critical changes in health care and health care reform that may make the delivery of medical care "go from a wholesale model, where large employers purchase care, to a retail model, where individual patients choose what services and service providers they will use." He outlined how healthcare providers must not only render good care, they must also be able to document that care. "We are increasingly being asked to prove the effectiveness of our efforts using a wide array of care scores," said Professor Liang. "We are particularly doing poorly at patient satisfaction, as are all healthcare providers. We need to see this as an opportunity to improve what we do and, importantly, how we can do it better for our patient populations."

Professor Liang is a noted expert on health policy, and has spoken to a wide array of groups on healthcare issues and reform. He is a physician, attorney, and health services researcher and works with healthcare organizations on quality, safety, and patient satisfaction issues.

Executive Director Bryan A. Liang Gives Professionalism in Audiology Presentation

June 22, 2009. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, gave an invited presentation to the combined University of California San Diego-San Diego State University audiology students on the present and future professionalism issues in audiology. His presentation was entitled, "Ethics and Professionalism in Audiology: Choosing A Model."

"The law takes a strong view of financial conflicts of interest, and audiology is at a crossroads. With sales of a product vying with a desire for professionalism, a choice of either business ethics, to maximize profits, or professional ethics, to maximize social good, will dictate how the field will grow," he noted. He also added that "In the next 25 years, more people will be over the age of 65 than under 18. The graying of America will lead to more demand for audiology. What role the field will play in the future will be dictated by decisions today."

Professor Liang was asked to speak by Professor Jacque Georgeson, Director of the Audiology Clinic at UCSD-SDSU.

Visiting Scholar Professor Fusako Seki GIves Comparative Health Systems Presentation at IHLS

June 16, 2009. Professor Fusako Seki, a visiting scholar at the Institute of Health Law Studies, gave a comparative health policy presentation for the California Western School of Law and broader community. Her presentation was entitled, “Looking at the U.S. Health Care System from Japan.”

In her presentation, she provided an introspective assessment of the insurer system, contrasting the Japanese system of public financing and uniform access with the U.S. system of private financing and variations in access. She noted that the differential in access also extended to high level services, which are more available in the U.S., compared with Japan. She concluded that both countries face similar challenges, and both systems have something to learn from the other.

Professor Seki is a social security and social welfare professor at Yokohama National University in Japan. She received her PhD in law from the University of Tokyo.

North County Times Features Interview with Professor Bryan Liang in Hospital Lawsuit Article

June 6, 2009. The competition in health care has intensified the focus on provider arrangements. However, diversion of emergency cases from in-network providers and other facilities cannot occur unless patients brought to an emergency room are given an appropriate medical screening examination and stabilized. Tri-City Hospital is in a conflict with Scripps Health in a case involving changed contracting providers and claimed inappropriate emergency transfers. The North County Times interviewed Professor Bryan Liang on the implications.

He noted that under federal law, patients must be stabilized and given an “adequate” medical screening examination before transfers from one emergency department to another hospital can occur. Further, under state law, patient must have “reasonable access” to care. Although contracting relationships allow in-network limitations, emergency cases and patient health cannot be jeopardized by these contracts.

The story is "Hospitals: Law Professor Sees Mixed Bag in Hospital Suit," by Paul Sisson in the June 6, 2009 edition of the North County Times.

IHLS Executive Director Bryan Liang and Research Associate Tim Mackey Publish Op Ed on Cybersecurity and Drug Safety

June 4, 2009. The Obama adminstration recently announced efforts to coordinate cybersecurity measures for the protection of U.S. citizens. Professor Bryan Liang and research associate Tim Mackey published an opinion editorial in the Los Angeles Daily Journal noting that this effort ignored a crucial patient safety concern: the purchase of medicines online.

Professor Liang and Mr. Mackey noted that this billion dollar industry involves tremendous criminal elements, risks the health and safety of patients, can result in identity theft, and creates a system of drug pushing from the streets to cyberspace. They also point out that search engines, unethical providers, and others profit off these sales with virtual impunity. They called for more intensive regulation and accreditation of Internet drug sellers using federal law.

The opinion editorial is entitled, "Searching for Cybersecurity: Accountability for Illicit Online Drug Sales," in the June 4, 2009 edition of the Los Angeles Daily Journal, page 6.

Congressional Testimony Features Research of Executive Director Bryan A. Liang

June 3, 2009. The healthcare reform debate has focused significantly on the cost of pharmaceuticals, and particularly on the price differences between brand name drugs and generics. However, policymakers are debating whether "authorized generics," i.e., generics sold by brand name companies during a period of legally-created sales exclusivity for independent generic drugs that successfully challenged brand name patents, should be allowed.

Professor Bryan A. Liang's research showed that drug prices were the roughly same when prohibiting authorized generic sales during the exclusivity period. His legal analysis also indicated that independent generic exclusivity should include brand name drug forms, including authorized generics. This work was cited in testimony in front of the House Committee on the Judiciary, Subcommittee on Courts and Competition Policy by Heather Bresch. Her testimony was entitled, "Pay to Delay: Are Patent Settlements That Delay Generic Drug Market Entry Anticompetitive?" on June 3, 2009.

Professor Bryan A. Liang Discusses Transplantation Policy Issues in California Lawyer Article

June 4, 2009. The criminal charges of dependent abuse in the Ruben Navarro case against transplant surgeon Dr. Hootan Roozrokh sent shockwaves through the medical transplant community. California Lawyer interviewed Professor Bryan Liang on the legal and policy implications of the case.

Professor Liang indicated that a significant part of the problem was the lack of standardization of transplant protocols, and the need for better public education on the systems in place for transplants. He also noted that this will become an increasingly important issue as the population ages, and the needs for transplants increase.

The article is "Cutting It Close: How a small-town DA’s office raised disturbing questions about the harvesting of organ," the cover story of the June 2009 issue of California Lawyer, by Tom Nichols.

Executive Director Bryan A. Liang Interviewed by KPBS on Department of Insurance Regulation

June 3, 2009. Illegal rescissions of health care insurance continue to attract policymaker attention. New regulations proposed by the California Department of Insurance have been released to address the issue. KPBS interviewed Professor Bryan Liang to get his reaction.

Professor Liang noted that the most important aspect of the announced regulations is that they may signal a commitment to enforcement of current law in this area. He added that the regulations closely mimic a 26 year old California Supreme Court case, and the regulations substantively are not different from the rights beneficiaries already have.

The story is "New Regulators Aimed At Preventing Health Insurers From Terminating Policies," by Kenny Goldberg, KPBS Health Reporter.

Los Angeles Times Interviews Professor Bryan A. Liang on Proposed Insurance Rescission Regulations

June 3, 2009. The illegal rescission of individual health policies continues to be an important policy issue. Anticipating the next California gubernatorial election, and reacting to national media coverage on the issue, Department of Insurance Commissioner Steven Poizner released proposed regulations to stem this practice. The Los Angeles Times interviewed Professor Bryan Liang on his reaction to these regulations.

Professor Liang noted that the standards in the regulations already represent established law under a 1973 California Supreme Court decision. He indicated that the key to reigning in the illegal industry-wide practice is for regulators to aggressively enforce these legal obligations.

The story is "Proposal would combat rescissions of health insurance policies in California," by Lisa Girion in the June 3, 2009 issue of the Los Angeles Times.

Professor Bryan A. Liang's Article on Internet Drugs Sellers Is Top Ten Downloaded Paper

June 1, 2009. Professor Bryan A. Liang's paper, co-authored with Research Associate Tim Mackey, "Searching for Safety: Addressing Search Engine, Website, and Provider Accountability for Illicit Online Drug Sales," published in volume 35 of the American Journal of Law & Medicine this year, was a Top Ten Downloaded Paper, in the Public Goods & Regulation in Health Economics, Social Science Research Network/Economic Research Network. The Social Science Research Network and Economic Research Network represent the largest source of social science and legal scholarship on the Internet, representing hundreds of thousands of academic papers, both published and unpublished.

"Having our work downloaded so extensively means, hopefully, that our work is substantive and of interest to the broader academic community," said Professor Liang. "The mission of IHLS includes research and advocacy in order to have an impact on health policy, and we are gratified that the attention to our work is consistent with this mission."

Executive Director Bryan Liang Gives Presentation on Substandard Drugs at Canadian Pain Conference

May 29, 2009. Executive Director Professor Bryan A. Liang gave a presentation at the Canadian Pain Society Annual Conference "Pain-Translating Science into Care" in Quebec City, Quebec, Canada. His presentation was entitled, "Pain, Therapeutic Failure, and Risks of Substandard Drugs: A Policy Analysis."

"Traditionally, therapeutic failure in control of pain is usually attributed to human variation associated with the underlying disease state and its effects on the human body," said Professor Liang. "However, with the globalization of the drug supply, vulnerabilities have arisen that include fake or substandard drugs, or unfettered patient access through the Internet resulting in overuse and dampening of their effects."

The Canadian Pain Society is an international organization of basic scientists and clinical providers performing research on pain mechanisms, therapeutics, and public policy.

Professor Bryan Liang Interviewed for Today/MSNBC.com Story on Generic Drug Safety

May 26, 2009. The globalization of the drug supply has resulted in challenges to safety and quality of medicines. However, not only new, brand name drugs are impacted, but so are generic drugs. In a story for the Today Show/MSNBC, Katherine Eban, an investigative reporter, interviewed Professor Bryan Liang on the issue.

Professor Liang noted that the limited inspection of overseas factories for generic drug manufacture is a huge regulatory loophole. He observed this is particularly risky today, as 90% of newly approved generic drugs are now manufactured overseas. He called for a much greater and more aggressive enforcement of generic drug manufacturers offshore, beyond simply setting up offices in foreign countries where access may still be limited.

The story is "Are generic drugs a bad bargain?," by Katherine Eban, available here.

Executive Director Professor Bryan A. Liang Interviewed by Los Angeles Daily Journal for Insurance Rescission Story

May 21, 2009. As the first trial court case for health insurance rescission has started juror selection, increased attention on the case has begun. The Los Angeles Daily Journal interviewed Professor Bryan Liang, a noted expert in the area, for his perspective.

Professor Liang noted that the case is unprecedented, and that usually insurance cases settle or go through arbitration. He observed that for an insurer to bring a case to trial is highly risky because juror sympathies lie “with the Davids, rather than the Gioliaths.”

The story is "Health Care Rescission Case Goes to Trial: Potential Jurors Show Why Health Cases Don't Go to Trial," by Evan George, on page 1 of the May 21, 2009 issue of the Los Angeles Daily Journal.

Professor Bryan A. Liang's Op Ed on Follow On Biologics Published by US News & World Report

May 18, 2009. The debate on healthcare reform has encompassed proposals to create a new approval pathway for “follow on biologic” drugs, which are copies of large scale protein biological drugs. However, there are challenges to adopting such a pathway using small, chemical pills and generics as the model.

Professor Bryan Liang outlined the scientific, medical, and policy concerns of follow on biologic drugs, and pointed to reforms that would ensure patient safety in his opinion editorial in the US News & World Report. He noted that legislative reforms must take into account the unpredictability of adverse events associated with new copies of biological drugs. Dr. Liang called for a unique naming system to rapidly identify drugs that could be associated with adverse drug events.

The opinion editorial is entitled, "High-Tech Medicines, Built to Mirror Originals, Can Have Dangerous Differences," in the May 18, 2009 issue of the US News & World Report.

Executive Director Bryan A. Liang Interviewed for LA Times Story on Health Insurance Rescission Trial

May 18, 2009. The first trial court case associated with health insurance rescission of individual policies has begun. With the national focus on health reform, the case has garnered significant attention. The Los Angeles Times interviewed Professor Liang on the ramifications.

Professor Liang noted that taking such as a case to trial may be a strategic misstep for the insurer. Given that there are significant risks of bad faith and punitive damages available, he said the jury may send a very clear accountability verdict to the insurance industry in this case.

The articles is "Blue Shield health insurance rescission case to go to trial," by Lisa Girion in the May 18, 2009 edition of the Los Angeles Times.

Professor Bryan Liang Interviewed by KPBS on Limited Participation in Insurance Rescission Settlement

May 14, 2009. The attention to the limited effectiveness of the California Department of Managed Health Care settlements within insurers who illegally rescinded patient insurance policies continues to increase. KPBS interviewed Professor Bryan Liang on these settlement results.

Professor Liang indicated that the limited participation in the settlements, coupled with the delays of regulations on the practice of rescissions indicates significant problems in the regulatory system. He called for an independent panel convened by the Legislature to assess and investigate the settlement, and provide recommendations for improving the process to ensure accountability for the insurers and appropriate benefits for patients.

Professor Liang was interviewed by Kenny Goldberg, KPBS Health Correspondent.

Los Angeles Daily Journal Interviews Dr. Bryan Liang on "Public Policy Failure" in Insurance Rescission Settlements

May 14, 2009. The illegal practice of health insurance recession by insurance companies has resulted in settlements between insurers and the California Department of Managed Health Care. Yet on analysis, only a small percentage of patients have actually obtained the benefits from these settlements. Professor Bryan Liang, a noted expert on the topic, was interviewed for his reaction.

Professor Liang noted that these figures were very disturbing, and represented a "public policy failure." He also indicated that this result represented a systemic problem with settlement implementation. He called for an independent panel to review the process to ensure that insurers are fully accountable for their previous illegal actions.

The story is "Despite Settlements, Rescission Victims Lack Relief: Rescission Victims Still Lack Coverage, Payments Despite Legal Settlements," by Evan George of the Los Angeles Daily Journal, May 14, 2009 issue, page 1.

NBC Radio Interviews Professor Bryan A. Liang on Healthcare Reform

May 7, 2009. With the increasing debate on health care reform, differing strategies are emerging. NBC Radio interviewed Professor Bryan Liang to review the options and what should be done.

Professor Liang noted that aggressive outreach for those already eligible for public insurance would cover 12 million persons, including 75% of uninsured children. Further, tax credits to allow employers to offer health insurance for low income workers and subsidies to purchase insurance based on sliding scale needs testing would cover millions more. He commented that reform is currently being stymied by partisan bickering, and that the issues of access must be addressed through achievable means to help patients now.

Wisconsin Radio KCUB Interviews Professor Bryan A. Liang on Swine Flu Developments

May 7, 2009. Public health authorities have updated figures on swine flu, showing infections in 41 states and 2 reported deaths in the US. KCUB interviewed Professor Bryan Liang to obtain his observations on this new information.

Professor Liang noted that the infection rates in Mexico were leveling off, and that US cases continued to be mild. However, he indicated that we should not let down our guard, since the southern hemisphere is starting its winter months and the flu may mutate and become more virulent in the flu season this winter. He also noted that the 1918 pandemic that killed greater than 20 million people worldwide also started as a mild flu that then recurred in a much more virulent form.

Professor Bryan Liang Publishes Opinion Editorial on Health Care Reform

May 5, 2009. The significant attention to healthcare reform has engendered debate as to what areas to focus upon. Professor Bryan Liang published an opinion editorial on the topic.

Professor Liang noted that two key areas are of greatest concern for costs and health of the US population: addressing chronic disease and the need for aggressive preventive health efforts. He outlined a proposal that includes a focus on wellness programs through tax incentives, early intervention, and aggressive public health education on disease prevention.

The piece is entitled, "Prevention and Education Programs Will Drastically Reduce Health Care Costs," in the May 5, 2009 edition of the San Francisco Daily Journal, page 6.

Executive Director Bryan Liang Interviewed on Swine Flu Concerns

May 4, 2009. With the announcement of a larger numbers of individuals with swine flu, concerns have been raised on its transmissibility and impact. Professor Bryan Liang was again interviewed about these developments.

Dr. Liang noted that cases were still mild outside of Mexico, but that we must stay vigilant and continue to assess the time frame for development of a vaccine. He noted that the virus could still mutate to become more infectious and deadly, and that with the coming winter months in the southern hemisphere, the country still needs to be prepared for a ore virlent strain to ememerge in the next flu season.

Professor Liang was interviewed by WKMA in Iowa and WRTA in Pennsylvania.

IHLS Program Administrator Pam Tait Attends IMQ Provider Conference as Appointed Mentor

May 1,2009. IHLS Program Administrator Pam Tait attended the California Institute for Medical Quality 2009 Provider Conference in Sacramento. This conference is held every year to recognize outstanding health providers and their mentors. Pam Tait is an IMQ appointed mentor for all organizational providers. In this role, she assists new and currently accredited CME providers who have questions and concerns regarding state standards.

IHLS is accredited to provide CME credits to medical professionals. It is the only law program in the US to be granted the power to grant continuing medical education credits.

Dr. Bryan A. Liang Discusses Widening Swine Flu Impact and Pandemic Potential

April 30, 2009. With the World Health Organization upping the swine flu level to 5 of 6, worldwide concern about the potential for a pandemic has dramatically increased. Professor Bryan Liang was interviewed for his insights on this new development.

Professor Liang noted that with established and sustained human-to-human transmission, WHO recognized the need to move the level up to signal countries to implement their emergency preparedness plans. Dr. Liang emphasized that hygiene, minimizing contact with ill patients, and avoiding non-essential travel to Mexico continued to be key strategies to limit the impact of the flu. He also advised that persons consolidate their routine trips, and consider alternative options for school-aged children and child care to limit exposure to public areas.

Professor Liang was interviewed by multiple stations, including WBAL (MD), WNNR (GA), WSCA (SC), KXL (National syndication), KZSC (CA), WSAU (WI), and WABC (National syndication).

IHLS attends Rady Children’s Hospital Auxiliary New Member Meeting

April 28, 2009 IHLS attended Rady Children’s Hospital Auxiliary new member meeting at the hospital. The Auxiliary provides support for the hospital programs by hosting fund raisers and supporting staff with their children-based programs. Both the Executive Director Bryan A. Liang and Program Administrator Pam Tait will join the “members at large” auxiliary group for 2009. They will continue to attend monthly meetings and support all children programs.

IHLS has participated in and supported the Rady Children's Hospital in numerous programs, including the annual Valentine's Day event since its inception.

Professor Bryan A. Liang Interviewed by Multiple Radio Stations on Swine Flu Concerns

April 28, 2009. The worldwide swine flu that originally was first reported in San Diego has increasingly caused concern for public health officials and the community around the country. Professor Bryan Liang was interviewed on the disease and implications for an effective response.

Professor Liang noted that the disease has been mild outside of Mexico, where dozens of patients have died. However, public health agencies have recommended that good personal hygiene, avoiding contact with those who are ill, and limiting non-essential travel to Mexico were key steps to contain the disease’s impact. However, he cautioned that the situation was dynamic, and that closely following the international developments was important to mitigate the circumstances and harm associated with transmission.

Stations that interviewed Professor Liang included nationally syndicated station WABC, and Connecticut stations WDRC, WMMW, WWCO, and WSNG.

IHLS Supports Kiwanis Run for Charity

April 26, 2009. IHLS assisted the La Jolla Kiwanis Club in its the 38th La Jolla Marathon Run held on April 25-26, 2009. IHLS helped 6,000 half marathon runners pick up their race packets as well as distributed t-shirts to all participants, including an additional 2,000 5K runners on Saturday, April 25th.

In addition, on Sunday, April 26th, IHLS assisted with all runners' apparel in Del Mar prior to the race and then shuttled them down to the finish line at the La Jolla Cove. At the Cove, IHLS assisted at the water station and at the finish line. The weather was perfect for the runners and it was a sold out event.

All proceeds from the Kiwanis Run are used to benefit youth and elder programs in the community.

Professor Bryan A. Liang Gives Presentation and Serves on Panel on Anti-Counterfeiting at PhRMA Law Section Meeting

April 22, 2009. Professor Bryan Liang was a featured speaker at the Pharmaceutical Research and Manufacturers of American's Law Section Annual Meeting. In addition, he served on an expert panel on counterfeit drugs at the meeting.

"The issue of counterfeit drugs is a public health scrourge that must be addressed here and around the world for patient safety purposes," Professor Liang noted. "To reform the current inoptimal response, public-private partnerships must be a cornerstone for effective prosecution and public protection."

Dr. Liang's presentation was entitled "Counterfeit Drugs: Issues for Public Policy." In the panel discussion that followed, entitled "Perspectives on Anti-Counterfeiting Initiatives for Pharmaceutical Products," he was joined by Julie Chalkin Hogan, Assistant Statewide Prosecutor, Florida Attoney General Office of Statewide Prosecution, and Evan Williams, Assistant U.S. Attorney, Computer Crime & Intellectual Property Section, Criminal Division, U.S. Deaprtment of Justice.

Executive Director Professor Bryan Liang Publishes Op Ed on Preventive Care and Health Reform

April 15, 2009. With the debate on health reform in full swing, critical high cost areas are gaining attention. Professor Bryan Liang published an opinion editorial on the aggressive use of preventive care strategies to improve health.

Dr. Liang noted that chronic disease disproportionately consumes most of the health care dollar in the US. Citing data on the beneficial clinical and financial impacts of early intervention and preventive care, he called for tax incentives for employers to offer their employees wellness programs, and AdCouncil efforts to improve public education on the impact of preventive care.

The op ed is entitled "Prevention the best medicine," in the April 14, 2009 edition of the Winona Daily Times. The piece was also picked up by several other media outlets across the United States.

Florida Newspaper Publishes Op Ed by Professor Bryan A. Liang on Student Health Bill

April 14, 2009. The increasingly apparent issue of uninsured students on campus has led to legislatures closely assessing approaches to improve access to health care. Professor Bryan Liang published an opinion editorial supporting these efforts in Florida.

Professor Liang noted that the student age group has one of the highest levels of uninsured across populations. However, he also noted that colleges and universities also create a "shadow uninsured" group who actually have private insurance but are prohibited from using it on campus. Schools thus represent intensified levels of uninsured. He called for support of two Florida bills that would allow students to use their private insurance on campus, and surpluses that result from such billing to be used to provide health insurance financial aid. Dr. Liang assisted in drafting one of these bills.

The opinion editorial is entitled "Addressing the shadow uninsured: college student access to health care," in the April 14, 2009 edition of the Florida Community News.

Los Angles Daily Journal Interviews Professor Bryan Liang on Health Insurance Billing Disputes

April 13, 2009. Insurer actions to avoid payment or negotiation of provider fees by paying patients directly have become a increasingly common strategy to limit out of network costs. The Los Angeles Daily Journal interviewed Professor Bryan Liang for his reaction on this approach.

Professor Liang noted that such an approach puts the power of determining fair compensation solely in the insurer’s hands. Further, the practice implicates the prohibition against balance billing. He called for regulators to clarify the legality of this approach.

The story is "Blue Cross Pays Patients in Bill Disputes: Providers Say the Program Wreaks Havoc on Industry," by Evan George, in the April 13, 2009 issue of the Los Angeles Daily Journal, page 1.

IHLS and HLS Hold Blood Drive to Support San Diego Blood Bank

April 2, 2009. With the increasing need for blood and blood products in the San Diego area, the Health Law Society and Institute of Health Law Studies conducted its second blood drive for 2009. With projection goals being set at 16 units, HLS and IHLS managed to collect 29 units on the day. Within these collections there were 8 double red units collected which is highly desirable at this time.

"As a former hospital blood bank director, I know how serious and important a shortage of blood and blood products represents," said Dr. Bryan Liang, E. Donald Shapiro Distinguished Professor and Executive Director of the Institute of Health Law Studies. "These continuing efforts by students and staff will go a long way to saving patients' lives."

The IHLS/HLS blood drives are advertised in the CWSL community as well as the San Diego community. Most of the donors were students during this drive. The donations benefit the San Diego Blood Bank and patients in the San Diego area.

Los Angles Daily Journal Publishes Follow On Biologics Opinion Editorial by Professor Bryan Liang

April 1, 2009. President Barack Obama has announced new efforts to improve the economy and underwrite health care reform, including use of “follow on” biologics, which are similar but not exact copies of large, high tech biological drugs. Professor Bryan Liang wrote in an opinion editorial on this critical topic.

Dr. Liang noted that the assumed savings of $9 billion dollars may not materialize because of the size, scientific status of drug characterization, and unknown side effects inherent in these drugs. The challenges of these biological drugs also include the fact that they may induce allergic reactions in patients because often these drugs are large protein molecules, rather than small relatively simply solid chemical pills obtained at the pharmacy. Finally, Dr. Liang also called for unique identifiers for these “follow on” forms to allow rapid identification and notification if patient safety issues arise.

The opinion editorial is "Plan for High−Tech Prescriptions Ignores Grave Safety Concerns," in the April 1, 2009 issue of the Los Angeles Daily Journal on page 6.

IHLS Hosts 5th Annual San Diego Health Policy Conference on Bio-Preparedness

March 27, 2009. The Institute of Health Law Studies hosted the 5th Annual Health Policy Conference, "Bio-Preparedness: Issues in Biowarfare and Pandemic Response." The conference was held at the Hilton Harbor Island Hotel in San Diego.

Executive Director of IHLS Professor Bryan Liang noted that "This is an especially important and timely event for all of us. Local factors, such as the extensive military presence here in San Diego, as well as national and international factors, such as avian flu and bioterrorist events, show us that bio-preparedness has unique characteristics that require us to look across people, affiliations, and roles to effectively plan for these kinds of disasters and emergencies."

The event drew participants from around the world, including Europe, Asia, as well as North America. Presenters included Dr. Michael Christian, University Health Network, Toronto, Canada, who discussed SARS lessons for pandemic planning and bioterrorism from both an academic and treatment coordination approach; Dr. Christian Sandrock, University of California, Davis Medical Center, who raised questions on ethical and equal care in a pandemic on the basis of his clinical work as well as being in leadership roles in the Yolo County Health Department; Lt. Commander James A. Balcius, who provided information on public health law and medical military assets, including an analysis of the legal concerns in federalizing national guard personnel; Dr. Marv Sheperd, College of Pharmacy, Univesrity of Texas at Austin, who reported on disasters, bioterrorism, and prescription drug access in emergency situations using lessons from Hurricane Katrina and Ike; Dr. Randall Murch, Virginia Polytechnic Institute & State University, who gave an extensive presentation on national and international components of biosecurity on the basis of his academic work and FBI leadership, field, and forensics experience; Dr. Thomas Novotny, Global Health, Graduate School of Public Health, San Diego State University, who provided insights into global governance for biopreparedness on the basis of his research and former position as Deputy Assistant Secretary of the Department of Health and Human Services; and Dr. Bryan A. Liang, Institute of Health Law Studies, California Western School of Law, San Diego Center for Patient Safety, University of California, San Diego School of Medicine, and Global Emergency Preparedness and Response Program, Graduate School of Public Health, San Diego State University, who discussed the international drug production and supply chain, and its challenges for biopreparedness and international diplomacy efforts.

In addition to IHLS hosting the event, the 5th Annual San Diego Health Policy Conference was supported by the San Diego Center for Patient Safety, University of California, San Diego School of Medicine, the Journal of Biolaw & Business, and the Partnership for Safe Medicines. The proceedings of the conference will be published in a forthcoming issue of the Journal of Biolaw & Business.

IHLS Executive Director Bryan Liang and Member Arlene Luu Give Elder Abuse Seminars at Southwestern Nursing School

March 23, 2009. The Institute of Health Law Studies provided an elder abuse education seminar to the Southwestern School of Nursing in Otay Mesa, CA. IHLS Executive Director Professor Bryan A. Liang, and IHLS Member Arlene Luu, RN, BSN, JD, of Kaiser Permanente, presented information about the signs and symptoms of elder abuse, and potential legal and policy concerns for nurses involved in senior care.

"It is nurses who spend the most time with patients, and are often the only contact with the outside world," said Professor Liang. "The combination of isolation and greying of our population has created a targeted population for abusers," he added. Ms. Luu noted that the system of care and vulnerabilities that may provide challenges to safety as well as expose the provider to liability.

Professor Liang and Ms. Luu have a broad base in elder care issues. They have published articles on improving quality and safety in health care for the senior population that have appeared the the Cornell Journal of Law & Public Policy as well as the Journal of Medicine & Law. Professor Liang serves on the Board of Directors of the National Committee for the Prevention of Elder Abuse.

Native American Times Publishes Op Ed by Professor Liang on Health Care Reform Proposal

March 16, 2009. The Obama administration recently released its long awaited budget, including its massive health care reform provisions. Professor Bryan Liang commented on key components in this budget that reflect the needs of minorities and other vulnerable populations in an opinion editorial in the Native American Times.

Professor Liang, in a "Dear Mr. President" format, noted that aggressive outreach for minority groups should be a first priority for health care reform since more than three-quarters of children and other uninsured citizens are already eligible. He also warned against focusing on political motivated solutions such as drug importation and approving "generic" versions of complex biological drugs, which put the risk of policy failure that focuses on cost savings on the most vulnerable patient groups.

The opinion editorial is "Letter to President Obama: The Right Medicine for Health Care Reform" in the March 16, 2009 edition of the Native American Times. Professor Liang has a long standing interest in minority health, including service on the Secretary of the US Department of Health and Human Services Advisory Committee on Minority Health.

Institute of Health Law Studies and Health Law Society Participates in Rady Children's Hospital St. Patrick’s Day Run

March 14, 2009. The Institute of Health Law Studies and student Health Law Society participated in the Rady Children's Hospital St. Patrick’s Day Run. The team’s name this time was the IHLS Green Machine.

Some of the team ran a 2 and 4 mile fun run with one leading student, Mr. Cameron Rhudy, completing the full 10K with a time under one hour. It was a beautiful day at Mission Bay that brought thousands of participants out to support such a worthy cause.

The IHLS Green Machine hosted a bake sale prior to the event to raise money for their registration. The walk benefited the life-saving efforts of Rady Children's Hospital and their treatment of critically ill children.

U.S. Pharmacist Webinar on Counterfeit Drugs Features Executive Director Bryan A. Liang

March 13, 2009. With the increased attention to drug costs and recent scandals associated with problematic medications, the issue of counterfeit drugs has become an important one for pharmacists. U.S. Pharmacist hence convened a webinar featuring noted expert Bryan A. Liang to discuss the problem.

"The counterfeit drug market has matured from faking lifestyle drugs such as Viagra to lifesaving drugs such as cancer therapies," said Professor Liang. "Pharmacists represent one of the last barriers to harm. They must educate and communicate with their patients, as well as remain vigilant about the developments in this key patient safety area."

The webinar was attended by over 200 pharmacists nationwide. Professor Liang is also the Vice President for the Partnership for Safe Medicines, an organization that promotes safety of the drug supply.

Professor Bryan A. Liang Participates in Webinar on Billing College Campus Health Centers

March 12, 2009. The policy debate regarding the uninsured has traditionally ignored the college-aged population. However, recent findings on the scope of high uninsured levels and overrepresentation in minority groups in higher education have raised attention to this issue. University Business held a webinar on the topic to discuss the implications, and the potential billing of third party insurers by schools to increase revenue as well as student access to care.

"Billing private health insurers -- through which 80% of students obtain coverage except while on campus -- benefits the student and the school," said Professor Liang. "Schools that reject this traditional elite calling card actually add to the numbers of uninsured on campus, since these students will act like typically uninsured students. To help the student body, we should be focusing on methods to address their healthcare needs -- and accepting their insurance is an important first step," he added.

Professor Liang was joined by Paul Ferguson, health center administrator of Georgia Southern University, and Harold Wittington, Vice President of Highland Campus Health Group.

Institute Sponsors Team in the California Innocence Project Dodge Ball Tournament

March 9, 2009. The Institute of Health Law Studies sponsored and entered a team of 7 participants to play in the annual California Innocence Project dodge ball tournament. The team’s name was the IHLS Drug Lords. The players were dressed in black and gold Drug Lord T-shirts, black bandanas and black undercover sunglasses.

The competition this year was intense but the team was ready for the heavy slinging of balls. It wiped the opposition out the first game with only losing one of our players. It them tied the second round to go to a tie breaker. During the third round the opposing team knocked out the IHLS team muscle resulting in a loss. The second round of play was no problem as the team was so intimidating that caused the opposition to a no show, so The Drug Lords won the round. However, on single elimination with other winning teams, the team did put up a fierce fight but was knocked out of the competition.

The tournament is a fundraiser for California Innocence Project, which assists wrongly convicted citizens to establish their innocence in the justice system.

Editorial by Professor Bryan Liang on Campus Health Coverage Published in University Business

March 1, 2009. With the advent of national insurance reform on the policy front burner, the hidden issue of access to healthcare on campus has gone unnoticed. Professor Bryan Liang published an opinion editorial in University Business to alert the policymaking community to the issue.

Profesor Liang noted that college-aged adults are disproportionately represented in the ranks of the uninsured. But the poor programs and limited benefits available in school-sponsored programs, as well as the inability for students with insurance to use it on campus, have created tremendous issues of access to health care for students. He called on policymakers to recognize these "shadow uninsured" and act to promote the health of students.

The opinion editorial is entitled, "Covering the Shadow Uninsured: What institutions can do to help ensure the health of their student bodies," in the March 2009 issues of University Business.

Los Angeles Times Quotes Professor Bryan A. Liang in Story on Excessive Insurance Rates

February 18, 2009. With the worsening economy, more people are looking to last resort health insurance options. Under HIPAA, insurers must offer their most popular coverage options to people whose COBRA coverage has run out, regardless of pre-existing conditions. California state law limits the premiums to be charged in these situations. However, some insurers are exceeding these amounts by 36%-55%. The Los Angeles Times interviewed Professor Bryan Liang on these findings.

"It has been clear by legislative history and policy that there was a bright line rule to be put into place on premiums," said Dr. Liang. "The whole point of the legislation was to ensure access to insurance. Excessive premiums in contravention of state law undermines that provision, and must be addressed."

The story is "Insurers exceed state-issued rates for last-resort health coverage," by Lisa Girion of the Los Angeles Times.

Institute of Health Law Studies Collaborates with Rady Children's Hospital Heart Institute

February 14, 2009. The Institute of Health Law Studies collaborated on the Second Annual Rady Children's Hospital Heart Institute Valentine Party. This is the second year in a row that IHLS has been a main participant in this communicty service event.

Pam Tait, IHLS Program Administrator with 11 Health Law Society students stuffed and handed out over 300 heart bags to pediatric heart patients and their families. The heart bags were designed and donated by IHLS this year . IHLS used the “go green” idea for the bags by constructing them from recycle coffee bags lined with teddy bear print. In addition, IHLS volunteers staffed several expo booths throughout the day. These included: a Home Depot booth that volunteers assisted patients and their families construct bird houses and book ends to take home. The IHLS members set up a bear bag toss game that generated fun and prizes for attendees. Inside the cafeteria we had several volunteers staff a “make your own bag” table where participants could stamp, color or paint a holiday bag to take home. Last but not least, a few members assisted with the food concessions as the lunch hour rolled around. It was a fabulous day filled with fun, laughter and lots of love!

IHLS continues its focus on community service. For additional information on events, contact Pam Tait, IHLS Program Administrator, for future projects.

Executive Director Bryan A. Liang Interviewed by KPBS on Health Net Settlement

February 12, 2009. The issues surrounding the individual insurance market in California took yet another dramatic turn with the announcement of the settlement with Health Net of over 800 insurance rescissions. KPBS interviewed Executive Director Bryan A. Liang on its implications.

"Clearly, this settlement will set a new standard with respect to all the pending cases on rescission in the state," said Dr. Liang. "With reinstatement of policies, damages payments to patients, $2 million to the state, $500,000 to charity, the bar is raised for all future suits against insurance company rescission practices," he added. "However, I think it would be insane for any insurance company to want to bring a case like this to court to allow 12 jurors to express their frustrations about the health care system."

The story is "Health Net Pays Out Millions to Settle Class Action Suits," by Kenny Goldberg of KPBS.

National Public Radio Interviews Professor Bryan A. Liang on College Health Insurance Story

February 5, 2009. The increasing costs of attending college includes the cost of health insurance. Yet colleges and universities do not accept private health insurance and often force students to purchase the school's plan. National Public Radio interviewed Professor Bryan Liang on the implications of this situation.

"Although 80% of students in higher education have private health insurance through their parents or otherwise, this elite calling card becomes worthless in many cases once the student arrives on campus," Dr. Liang said. "Further, school-sponsored plans vary tremendously in coverage and quality," he added. "Schools should fulfill their fiduciary duty of being good stewards of students' money and accept private health insurance, and not force them to buy coverage they already have." Professor Liang noted this could be a win-win situation for schools and students. "In fact, by doing this, schools can create a surplus that then can be used to provide health insurance scholarships for uninsured students."

The story is "Colleges Health Insurance Fees Questioned," on the February 5, 2009 edition of NPR's Morning Edition.

IHLS and HLS Hold Blood Drive to Support San Diego Blood Bank

February 3, 2009. The Health Law Society and Institute of Health Law Studies held a blood drive in support of the San Diego Blood Bank. HLS and IHLS collected 32 pints of blood for the community. These consisted of 20 whole blood and 10 double reds units collected. The amount exceeded its goal by more than 30%.

"As a former blood bank director, I know how much community blood drives really provide the gift of life," said Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, who is also a physician. "The efforts of HLS and IHLS provide so many patients with health benefits that they could not obtain any other way."

The IHLS/HLS blood drive is a quarterly event that involves the participation of faculty, staff and students at the Institute of Health Law Studies.

Institute of Health Law Studies Begins "Warm A Heart" Clothes Drive for the Needy and Homeless

February 1, 2009. The Institute of Health Law Studies began its annual "Warm A Heart" clothes drive today. Each year, IHLS collects clothes to assist the needy and homeless.

"In these hard economic times, the Institute's 'Warm A Heart' clothes drive is even more important than ever," said Executive Director Bryan A. Liang, "Although giving back to the community is always important, the demand for assistance has recently really increased, and we are fortunate to be able to contribute our part to address some of community's needs."

The "Warm A Heart" Clothes Drive continues throughout the month of February. Cannisters in the 350 Cedar Street Building are marked for donations. The "Warm A Heart" Clothes Drive is coordinated by IHLS Program Administrator Pam Tait.

California Lawyer Quotes Executive Director Bryan A. Liang In Health Insurance Rescission Story

February 1, 2009. The tremendous attention given to health insurance rescission has prompted private litigation and public reform efforts. California Lawyer interviewed Professor Bryan Liang, a noted authority, on this trend.

Professor Liang indicated that rescission in the individual health insurance market has been increasing as this market grows larger due to a greater number of employers dropping health coverage for their employees. He also stated that the combination of private and public litigation has created a new system of enforcement that may be effective in reigning in insurance company abuses.

The story is "Coverage in Tatters," by Jeannette Borzo in the February 2009 issue of California Lawyer.

Rady Children's Hospital Advanced Trauma Symposium Features Presentation by Professor Bryan Liang

January 30, 2009. The Rady Children's Hospital Advanced Trauma Symposium featured a presentation by Professor Bryan Liang on emergency preparedness and response pre-planning and the challenges of disaster outcomes after they occur.

"Emergencies and disasters require us to understand how we will dedicate resources in a time of extreme scarcity. It is critical for us to know what system of allocation we will use, whether it be life priority, even chance, or the military model," he noted. "Transparency is key to an acceptable albeit imperfect outcome when all cannot be saved."

But Professor Liang emphasized that hindsight perceptions can be harsh. "As noted in the Dr. Anna Pou Katrina case, the lenses can be tinted quite critically to allow even criminal prosecution of those who attempt to treat in the most difficult of all situations," he said. "We need to remember that when pre-planning for how we respond to emergencies and disasters."

Dr. Liang's presentation was entitled, "In the Darkest Day and the Blackest Night: Planning and Perspectives on Emergency and Disaster Response." He was invited to speak by Mary Hilfiker, MD, PhD, Department of Pediatric Surgery, Rady Children's Hospital.

Dr. Bryan Liang Gives Public Health Lecture at University of California San Diego Preventive Health Seminar Series

January 30, 2009. Dr. Bryan Liang, Executive Director of the Institute of Health Law Studies and E. Donald Shapiro Distinguished Professor, presented a lecture on the scope of public health powers in the University of California, San Diego School of Medicine-San Diego State University School of Public Health Preventive Health Seminar Series.

"Public health powers are based on the state police powers in the US Constitution," said Professor Liang. "These give public health professionals significant power to protect the public health. But in emergencies and disasters, those powers are even more expanded, so that individual rights, professional rights, private property rights, and privacy right all give way."

Dr. Liang's presentation was entitled, "Legal Issues and Powers In Addressing Public Health Emergencies." In addition to being on the faculty of California Western School of Law, he is also on the faculty at University of California, San Diego School of Medicine and the San Diego State University Graduate School of Public Health.

Professor Bryan Liang Meets with Florida Officials on Strategies to Combat Pharmaceutical Fraud

January 23, 2009. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, met with State of Florida prosecutors to discuss strategies to combat pharmaceutical fraud and promote patient safety. Dr. Liang is a well-recognized expert on the challenges of drug supply chain security, and testified in the Papito case, where Florida prosecutors obtained a 20 year sentence for illegal diversion of drugs.

"Florida has some of the best laws and investigative talent in fighting pharmaceutical fraud," said Professor Liang. "In combination with some of the policy and industry efforts and recognition of important international trends, we can develop a system that can be proactive in ensuring that patients get the legitimate drugs they need and criminals are prosecuted for defrauding patients and the public who pay for these drugs."

Dr. Liang met with Ms. Julie Hogan and Mr. Oscar Gelpi of the Florida Office of Statewide Prosecution. Ms. Hogan was the prosecutor in the Papito case, and Mr. Gelpi was one of the authors of the Florida 17th Statewide Grand Jury Report, which was a catalyst for legislative change to address pharmaceutical fraud in the state.

KPBS Radio Interviews Professor Bryan Liang on Multi-State Conscience Clause Lawsuit

January 16, 2009. The outgoing Bush Administration has proposed "conscience clause" regulations that would allow providers to refuse to provide services or products that violated their moral or ethical beliefs in federally funded medical care programs. Several states, including California, have joined a lawsuit to prevent implementation of the regulations. KPBS radio interviewed Professor Bryan Liang on the issues involved in the suit.

Professor Liang noted that although providers have the right to their own moral and ethical beliefs, he indicated that states were concerned that access to healthcare and women's rights would be compromised. This is particularly true because there are no provisions to address emergency circumstances within the proposed regulations. Professor Liang stated that belief systems of any person are covered by the US Constitution, but cannot "serve as a blockade at the hospital doors."

Professor Liang was interviewed by Kenny Goldberg, KPBS health law reporter.

Los Angeles Times Quotes Professor Bryan Liang on California Supreme Court Balance Billing Case

January 9, 2009. The California Supreme Court weighed in on the issue of provider "balance billing" for emergency medical care when patients are not using the health plan's network. In this closely watched case, the California Supreme Court held that emergency physicians and hospitals could not bill patients for amounts not paid by their health plans or insurers. The LA Times interviewed Professor Bryan Liang on the decision.

Professor Liang indicated that the holding was probably appropriate, and that payment disputes between providers and plans for out of network emergency services should not put the onus on patients. However, he noted that the court avoided the critical issue of what payment is "fair and reasonable" for out of network emergency care as required by California law. He indicated that the Department of Managed Health Care and the Department of Insurance would have to define this, since health plans and insurers cannot unilaterally determine what this amount should be.

The story is "Ruling removes billing headache from emergency room visits," by Lisa Girion in the January 9, 2009 issue of the Los Angeles Times.

Professor Bryan Liang Interviewed by Pharmaceutical & Medical Packaging News on Drug Safety

January 6, 2009. Safety of the drug supply has emerged as a significant policy issue for the new administration. Pharmaceutical & Medical Packaging News interviewed Professor Bryan Liang on what to expect from the Obama team.

Profesor Liang noted that Obama will likely take an aggressive regulatory approach to safety rather than rely on voluntary industry efforts. Professor Liang also noted that issues with foreign importation of drugs and foods that have been the subject of poor quality and safety will likely weigh on discussions regarding packaging and other methods to ensure safety.

The story is "New Year, New President, New Packaging?" of the January 6, 2009 issue of the Pharmaceutical & Medical Packaging News.

Los Angeles Daily Journal Publishes Opinion Editorial by Professor Bryan Liang on "Shadow Uninsured"

December 23, 2008. With the upcoming new administration focused on health insurance, many have called for greater and more comprehensive coverage. Professor Bryan A. Liang published an opinion editorial piece in the Los Angeles Daily Journal noting that the college aged population--the "shadow uninured"--should not be forgotten.

Professor Liang pointed out that the college-aged population has the greatest percentage of uninsured, particularly amongst minorities. He also noted that they represent more than $355 million in uncompensated care each year. He called for policy changes, including permitted use of parental insurance on college campuses, access to programs modeled after the small and individual insurance market in each state, and inclusion of health insurance costs as a "cost of attendance" so health insurance premiums can be eligible for financial aid.

The op ed is "Covering the Shadow Uninsured: Ensuring the Health of the Student Body," in the December 23, 2008 edition of the Los Angeles Daily Journal.

KPBS Radio Interviews Professor Bryan Liang on Good Samaritan Case

December 19, 2008. The California Supreme Court handed down a decision that indicated the state’s Good Samaritan Law only applies to emergency assistance that is medical in nature, and non-medical emergency assistance is not covered by the law’s immunity provisions. KPBS Radio interviewed Professor Bryan Liang on the decision and its implications.

Professor Liang noted that the decision was bad public policy because of the arbitrary distinction between medical and non-medical assistance, and indicated that it would chill victim assistance efforts in emergencies. He called for the legislature to address the issue by either new law or a legislative resolution clarifying that it did not intend such limits as interpreted by the California Supreme Court. He also noted that the law itself did not contain any limitations on emergency assistance nor use the term "medical" to limit its immunity provisions.

The case is Van Horn v. Watson, California Supreme Court, filed December 18, 2008. Professor Liang was interviewed by Kenny Goldberg, KPBS Healthcare Reporter.

Dr. Bryan A. Liang Comments on Transplant Surgeon Verdict in Dependent Adult Abuse Case

December 19, 2008. The trial of transplant surgeon Dr. Hootan Roozrohk for dependent adult abuse because of his allegedly inappropriate participation in the care of potential organ donor Ruben Navarro was decided by a not guilty verdict. The San Luis Obispo Tribune interviewed Professor Bryan Liang on his reaction to the verdict.

Dr. Liang noted that the verdict was a relief both to the transplant provider community as well as patient community. This situation was a result of confusion as to protocol, not a criminal circumstance as claimed by the prosecution. Dr. Liang also pointed out that the case has resulted in important standardization of the donation after cardiac death transplant policies across the country.

Th story is "Transplant surgeon Hootan Roozrokh acquitted in Sierra Vista organ harvest case," by Leslie Parrilla in the December 19, 2008 edition the San Luis Obispo Tribune.

Follow-on Biologics Opinion Editorial by Dr. Bryan A. Liang Published by The American

December 12, 2008. The incoming Obama administration has indicated it will facilitate approval of follow-on biologics, or copies of brand name originator biological drugs. Professor Bryan Liang published an opinion editorial commenting on this approach in The American.

Professor Liang indicated that although rapid access to biologic drugs is important, their unique characteristics and limited scientific knowledge on determining their structure has resulted in adverse events that have harmed patients. He urged that the European model for regulating these drugs be adopted by the US, and that unique naming of each follow-on biologic that is approved is mandated to rapidly identify patients who have taken the drug if recalls are necessary.

The op ed is entitled, "Big Macs and Biologics," in the December 12, 2008 website edition of The American.

Professor Bryan Liang Interviewed by San Francisco Daily Journal on $3.9 Million Verdict Against Kaiser-Permanente

December 10, 2008. Southern California Permanente Medical Group and Kaiser Foundation Health Plan were hit with a $3.9 million verdict against them for retaliatory discharge by a physician who was advocating for quality care. The Los Angeles Daily Journal asked Professor Bryan Liang for his reaction.

Professor Liang noted that this was an important case for physicians and vindicated quality efforts, which are protected by California law. This was also an important case because sometimes these efforts may be confused with “disruptive behavior”, which hospital accreditation rules have prohibited.

The story is "Jury Shocks Kaiser with $3.9 Million Award to Whistle-Blower," by Evan George, in the December 10, 2008 issue of the San Francisco Daily Journal, page 2.

Executive Director Professor Bryan A. Liang Comments on Patient Internet Use to Choose Providers

November 30, 2008. Increasing health care provider rankings available on the Internet have been touted as a competitive answer to improve quality of care. However, the use of these ranking has been questioned. The Riverside Press-Enterprise interviewed Professor Bryan Liang on the topic.

Dr. Liang indicated that although the Internet has been an increasing force in providing information to consumers about diseases and treatment, it has not been used by patients to obtain information about health care providers. Patients continue to use traditional means of personal experience and familiarity with the provider or entity to make judgments about specific health care providers.

The story is "Few consult online health care ratings, studies say," by Lora Hines, in the November 30, 2008 edition of the Riverside Press-Enterprise.

Executive Director Bryan A. Liang Featured in Kaiser Permanente Newsletter

December 1, 2008. Executive Director Bryan A. Liang was featured in the December Kaiser Permanente West LA Connection Newsletter. The story, "How to Succeed in the Health Care Business: Quality, Safety, and Patient Centered Care, A Conversation with Dr. Bryan Liang," was a detailed discussion with Dr. Liang on the key components to promoting healthcare business success. He emphasized that the need to focus on quality and safety in combination with the needs of patients can provide important opportunities for success in the increasingly competitive market. Dr. Liang is a well known policy expert on the healthcare industry, with over 300 publications and presentations in a wide array of forums.

Dr. Bryan A. Liang Serves as Expert Witness for the Prosecution in Drug Diversion Case

November 24, 2008. Dr. Bryan A. Liang, Executive Director of the Institute of Health Law Studies, acted as a public health expert witness for the State of Florida in the criminal case of the State of Florida v. Jose Luis "Papito" Perez. Perez was engaged in diverting pharmaceuticals from Medicaid recipients, repackaging these diverted drugs under unsafe and unsanitary conditions, and reselling these poor quality products to other Medicaid patients and billing the government.

Dr. Liang focused on the harm to patients who never received the drugs, patients who received poor quality drugs, and the harm associated with the high costs to retreat patients. These drugs included lifesaving drugs for cancer and patients afflicated with HIV. He also noted that the billions of dollars spent by the public on fraud benefiting the Perez enterprise also prevented expansion of the Medicaid program to others in need.

Dr. Liang was asked to testify by Florida Chief Assistant Prosecutor Julie Hogan.

Executive Director Bryan Liang's Opinion Editorial on Health Insurance Access Published in San Diego Union Tribune and Los Angeles Daily Journal

November 20, 2008. Comprehensive healthcare reform due to the economic downturn may be limited. However, Professor Bryan Liang indicated that there are methods to address at least partially the problem of access to health insurance.

Professor Liang urged President Obama to enroll all those eligible for public health insurance. He noted that there are 12 million persons, including three-quarters of children without insurance, who are eligible but not enrolled. Professor Liang also proposed to auto-enroll the five million persons eligible for private insurance but who have not signed up. Finally, he indicated that small businesses should be allowed to aggregate to purchase cheaper group insurance and the government should provide subsidies to small employers and employees with limited incomes to purchase health insurance.

The editorials are "Expand access to health insurance" in the November 20, 2008 issue of the San Diego Union Tribune, page B7, and "Dear President Obama: Three Ways to Expand Access to Health Insurance Now" in the November 20, 2008 issue of the Los Angeles Daily Journal, page 6.

Professor Bryan A. Liang Addresses Permanente Medical Group on Future of Health Care

November 18, 2008. Professor Bryan A. Liang was invited to address the Permanente Medical Group, Southern California Regional Meeting, as to the future of health care delivery. The Permanente Medical Group is the physician component of Kaiser Permanent Health Plan.

Professor Liang noted that the challenges of the health delivery system will be intensified with the economic downturn. However, he observed that Permanente Medical Group, and Kaiser Permenente, has all the components to not only survive the future of health care delivery, but be a leader in the area: "With community networks, centers of clinical excellence and quality, a hospitality focus, and the status of a being a price leader, KP has the potential to show the US how healthcare can and should be delivered."

Professor Liang, who is a physician, lawyer, and policy advocate, was asked to present by Howard Fullman, MD, director of the West Los Angles Kaiser Permanent Medical Center. Dr. Liang's presentation was entitled, "Facing the Future: Addressing Market Pressures to Promote Health Care Delivery."

Executive Director Professor Bryan A. Liang Presents on Conflicts of Interest at National Hemophilia Foundation Annual Meeting

November 14, 2008. The challenges of increasing support of patient groups by private interests have created significant potential for conflict of interest. This is particularly true in addressing the needs of hemophiia patients, whose treatments can costs hundreds of thousands of dollars annually. The National Hemophilia Foundation asked Professor Bryan A. Liang to assist hemophilia chapters to address these concerns through conflict of interest recognition and policies.

Dr. Liang noted that conflicts of interest are not good or bad--they simply represent a description of reality that must be managed. He outlined an approach to focusing on how and when conflicts occur, warning signs, and themes of performance. Finally, he provided a strategy on crafting conflict of interest policies that are sensitive to local chapter concerns.

Dr. Liang's presentation was entitled, "Conflicts in Care: Issues for Hemophilia Chapters." He was invited to speak by CEO of the National Hemophilia Foundation Mr. Val Bias.

Bryan A. Liang Gives Ethics, Public Health, and Patient Safety Presentations at Critical Care Canada Forum

November 13, 2008. Bryan A. Liang, E. Donald Shapiro Distinguished Professor and Executive Director of the Institute of Health Law Studies, gave three presentations at the Critical Care Canada Forum in Toronto, Canada. He was the only faculty at the event to be asked to give this number of presentations at the event.

Professor Liang presented on the ethics of providing care during emergencies, and the means of allocating resources during this process in his presentation, "Perceptions of Professional Actions: Ethics, Disasters, and Priorities." The key powers of public health authorities in the USA was the focus of "Public Health Emergencies and Powers: Duty to Care from a USA Perspective." Finally, in his presentation "In Situ Simulation: Addressing Communications and Systems Issues in High Intensity Clinical Settings," Professor Liang gave details on using simulation methods within the facility and using teams operating in that environment to improve patient safety.

Critical Care Canada Forum is an annual conference focusing on topics that are relevant to the individuals involved in the care of critically ill patients, wherever the patients are located.

Executive Director Professor Bryan A. Liang Quoted in Front Page LA Daily Journal Piece on Insurance Rescission

November 7, 2008. The challenge of the Los Angeles City Attorney to the California Department of Managed Health Care's belief that it has sole jurisdiction over settlements of health insurance rescission cases has resulted in confusion over the propriety of the City Attorney to enforce state law involving managed care plans in the area. The Los Angeles Daily Journal interviewed Professor Bryan Liang to get his perspective.

Professor Liang noted that there is a direct conflict between state supremacy in law enforcement under the law and powers of city attorneys under the Unfair Competition Laws. He indicated it is likely that there will need to be some appellate review to resolve the issue.

The story is "State Tries to Block 'Fishing Expedition' Against Blue Cross," by Evan George, in the November 7, 2008 issue of the Los Angeles Daily Journal, page 1.

Professor Bryan A. Liang Publishes Op Ed on Increasing Health Insurance in Philadelphia Inquirer

November 5, 2008. With the election of Barack Obama as President, it is widely accepted that health care reform will be a major issue on the policy agenda. Professor Bryan Liang published an opinion editorial in the Philadelphia Inquirer urging the President and Congress to substantively take three steps to provide health insurance to more persons: enroll those already eligible for public programs, auto-enroll those eligible for private insurance, and grant small companies tax credits to offer health insurance and subsidize employees to obtain that insurance.

Professor Liang indicated that aggressive outreach to enroll those already eligible for public programs is important since 12 million Americans, including three-quarters of uninsured children, are in this group. Further, auto-enrolling those eligible for private insurance with an opt-out provision is similar to the method used by the federal government for its employees and has been successful in increasing participation in pension plans, particularly amongst low wage workers. Finally, granting small companies tax credits to offer insurance and subsidize employees for whom insurance is a large fraction of their income has been shown to increase access to care in California and may be a good model for the US.

The editorial is "3 Steps to Wider Health Care" in the November 5, 2008 issue of the Philadelphia Inquirer.

Bryan A. Liang Gives Lectures on Patient Safety and Legal Medicine at UCSD School of Medicine

November 4, 2008. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, gave a series of two lectures to the University of California, San Diego School of Medicine Class of 2011.

In the first, he provided an overview of the critical tools to ensure patient safety and address medical errors in the health delivery system. Using the "six pack plus one" system, he explained that the goal for providers is to both eliminate preventable errors but also to make the system resilient to inevitable error occurrence.

In the second lecture, he explained the legal accountability systems impacting medical care. He focused on the tort system, fraud and abuse, and policy issues surrounding how the legal system attempts to ensure appropriate care to patients.

Professor Liang was asked to present these lectures by Professors Rick Kronick, PhD and Rusty Kallenberg, MD, of the Department of Family and Preventive Medicine.

Executive Director Bryan A. Liang and Institute Member Arlene Luu Give Community Elder Abuse Presentations

October 23, 2008. Institute Executive Director Bryan A. Liang and Member Arlene Luu gave community presentations on at the Southwestern College of Nursing in Otay Mesa, CA. Their focus was the topic of elder abuse.

Professor Liang began with the signs and symptoms of elder abuse to provide the audience of health care providers a system to detect and report this abuse. Ms. Luu followed with a presentation on the legal aspects of elder abuse investigation and possible prosecution using case studies from her practice.

Professor Liang and Ms. Luu have published several articles on elder abuse for the law, provider, and policy audience. Professor Liang also serves on the Board of the National Committee for the Prevention of Elder Abuse and is a member of the Elder Justice Coalition.

San Diego Business Journal Quotes Bryan A. Liang on Presidential Health Reform Plans

October 20, 2008. The differing strategies for health care reform of the two Presidential candidates were a major and confusing topic in the last Presidential debate. The San Diego Business Journal asked Professor Bryan Liang for clarification.

Professor Liang noted that with only 4/10 voters indicating they understood both plans, and the candidates having moved away from their original conceptions, it is understandable that voters would be confused. He also indicated that neither plan would survive intact in Congress, and the financial sector’s woes will have tremendous impact upon any reform efforts. Deregulation of the insurance industry, as proposed by John McCain, would be poplitically unpopular, and expanded coverage and mandates, as proposed by Barack Obama, would be difficult to underwrite due to high costs, Professor Liang observed.

The story is "Politics Changing the Face of Health Care: Election Could Mean Insurance Updates to Employee Handbooks" by Heather Chambers, in the October 20, 2008 edition of the San Diego Business Journal.

Professor Bryan A. Liang Interviewed by KPBS for Medical Marijuana Story

October 17, 2008. A tremendous debate has been ongoing about the legality of medical marijuana in California. This has recently come to a head with the California Supreme Court rejecting San Diego County's lawsuit to challenge state law on allowing medical marijuana use, and the county's appeal to the US Supreme Court. KPBS radio interviewed Professor Bryan Liang on the implications.

Professor Liang noted that the Constitutional issue of federalism will play a large role in any review, including the state power to regulate public health and welfare. He also indicated that f the US Supreme Court agrees to hear the case, it will likely review the laws in 11 other states similar to California in its decision.

Professor Liang was interviewed by Kenny Goldberg, Health Reporter for KPBS radio.

Visiting Scholar Professor Fusako Seki Joins Institute of Health Law Studies

October 15, 2008. Visiting Scholar Professor Fusako Seki joined the Institute of Health Law Studies for an extended period to perform research on US health systems, particularly Medicare and elderly support programs. Professor Seki is a professor of social welfare law in the Department of International and Business Law, International Graduate School of Social Sciences, Yokohama National University in Japan.

"Having an internationally known scholar like Professor Seki with us here at the Institute is a unique and wonderful opportunity to collaborate on a wide array of health policy issues," said Executive Director Bryan A. Liang. "We are very fortunate to have Professor Seki sharing her wisdom with us and participating in our programs and educational activities here at the Institute and California Western School of Law."

Professor Seki will be visiting at IHLS during the 2008-2009 academic year.

IHLS and HLS Hold Blood Drive to Support San Diego Blood Bank

October 9, 2008. The Health Law Society and Institute of Health Law Studies held a blood drive in support of the San Diego Blood Bank. HLS and IHLS met its goal of collecting almost 30 pints of blood for the community.

"The gift of blood is the gift of life in many medical situation," said Dr. Bryan A. Liang, Executive Director of the Institute of Health Law Studies. "By supporting the San Diego Blood Bank, the Institute and Health Law Society truly make a difference in patient care in our community."

The IHLS/HLS blood drive is a quarterly event that involves the participation of faculty, staff and students at CWSL.

Institute of Health Law Studies and Health Law Society Participates in Rady Children's Hospital Sea World Shamu & You Family Walk

October 4, 2008. The Institute of Health Law Studies and student Health Law Society participated in the Rady Children's Hospital Sea World Shamu & You Family Walk. The "Whale Walkers" lead by IHLS Program Administrator Pam Tait had a team of 12 members, with the yougest member only 3 months old.

"IHLS and HLS efforts to support Rady Children's Hospital is a wonderful effort to support our community," said Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies. "Pam and the Whale Walkers' efforts show the dedication of the Institute and CWSL in service to those less fortunate."

The IHLS/HLS Whale Walkers raised almost $1,000. The walk benefited the life-saving efforts of Rady Children's Hospital and their treatment of critically ill children.

Dr. Bryan Liang Interviewed on Internet Drug Purchasing by Public Affairs Radio Program

October 3, 2008. The increasing costs of drugs has pushed some patients to consider purchasing drugs online. The Public Affairs program of WFTI Radio interviewed Professor Bryan Liang to ask how patients can do this safety.

Professor Liang, both a physician and lawyer, indicated that patients should only buy drugs from online sellers approved by the National Association of Boards of Pharmacy VIPPS accreditation program. Because of the ease by which unethical or criminal actors can set up web sites to sell counterfeit drug products, Dr. Liang emphasized that purchasing from unregulated and unaccredited sites can be risky and dangerous.

The WFTI Radio Public Affairs program is a weekly public affairs show hosted by Bob Barnes.

Executive Director Professor Bryan A. Liang Quoted in LA Daily Journal Story on Recalled Heparin

October 1, 2008. The discovery of over 90 California hospitals in violation of the heparin recall has prompted fines the by the state Department of Public Health. The Los Angeles Daily Journal asked Professor Bryan Liang for his perspective.

Professor Liang noted that ignoring the national recall of heparin was a tremendous liability risk, and that hospitals should have promptly reacted to the recall notices. He added that a systems analysis would be important to understand why so many hospitals missed the order so as to avoid a similar result for recalled drugs in the future.

The story is "Errors Let Recalled Drug Reach Patients" by Evan George in the October 1, 2008 issues of the Los Angeles Daily Journal, on page 1.

Los Angeles Daily Journal Publishes Op Ed on Drug Safety by Professor Bryan A. Liang

September 25, 2008. With the increasing reports of tainted products from overseas, both Presidential candidates Barack Obama and John McCain are backing away from importation of pharmaceuticals. Professor Bryan Liang published an op ed in the Los Angeles Daily Journal outlining the problems of foreign product regulation.

Professor Liang discussed the example of heparin from China, which killed more than 80 people, as well as other examles of poorly regulated offshore products. He indicated that better solutions, including low cost/no cost drug programs for the poor using regulated drug products, should be considered instead.

The op ed is "Recognizing a Prescription for Disaster," in the LOS ANGELES DAILY JOURNAL, September 25, 2008, at page 6.

Professor Bryan A. Liang Discusses Parallel Trade in Pharmaceuticals and Public Health Implications

September 24, 2008. Professor Bryan A. Liang discussed the implications of parallel trade in pharmaceuticals and the public health implications at the XIVth World Congress of Psychiatry, held in Prague, Czech Republic. He focused on the challenges of the mental health patient.

"The issue of parallel trade, which allows drugs to be brought over country borders without rigorous tracking, creates public health risks for vulnerable patient populations," Dr. Liang noted. "The Internet and other means allow mental health patients to obtain pharmaceutical agents with little if any oversight, representing a tremendous public health and policy problem."

The presentation was entitled, "Parallel Trade and Public Health: Risks to Vulnernable Patient Populations."

Executive Director Bryan A. Liang Gives Patient Safety Presentation at European Association on Communication in Healthcare Annual Meeting

September 3, 2008. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, gave a patient safety presentation at the European Association on Communication in Healthcare Annual Meeting in Oslo, Norway. His focus was on the use of simulation identifying communications and systems issues in healthcare delivery systems.

"Well coordinated communications and systems are key in promoting patient safety," he noted. "Using in situ simulation, which focuses on the actual people providing care at their own site, and not in an artificial laboratory setting, can provide insights into proactive changes designed by the participants to improve safety locally," he added.

The presentation was entitled, "In situ simulation: Identifying communications and systems issues in high intensity clinical settings to promote patient safety."

Professor Bryan A. Liang Publishes Op Ed on College Health in the Baltimore Sun

September 1, 2008. With students returning to colleges and universities, a prime concern is their health insurance coverage. Professor Bryan A. Liang outlines the dire circumstances for students if injured at school.

"Students are one injury away from bankruptcy or an inabiity to attend school if injured because of the limited coverage schools provide," he said. "These college-sponsored programs are massively profitable for insurers but provide little coverage for students. Further, to add insult to injury, students with private health insurance are no better off because schools don't accept private health insurance."

Professor Liang called for standards to be issued by college accreditors for scope of coverage in college health programs. He also called for policymakers to closely follow the situation.

The op is is entitled, "Covered on campus?" in the September 1, 2008 edition of the Baltimore Sun.

Executive Director Bryan Liang Interviewed on Presidential Healthcare Positions

August 27, 2008. The competing health care plans of the Democratic and Republican candidates represent starkly different views of health care reform. KMJ News, Fresno, interviewed Professor Bryan Liang for his perspective.

Professor Liang noted both plans were weak. He indicated that the Obama plan could create unrestrained costs while the McCain plan would not allow for easy comparison between insurance products. Importantly, both plans would allow insurers to price high cost patients out of the market. He indicated that insurer practices had to be reigned in to create a better system of coverage for citizens.

Professor Liang was interviewed by Inga Barks for the Inga Barks show.

Professor Bryan A. Liang Appointed to National Quality Forum's Expert Panel on Common Formats

August 19, 2008. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, was appointed to the National Quality Forum's Expert Panel on Common Formats authorized by the Patient Safety and Quality Improvement Act of 2005. This high level panel has 19 members from around the world who are experts in patient safety, and will advise the US Agency for Healthcare Research and Quality on data and information formats to promote patient safety in the US.

The National Quality Forum is a consensus standards-setting organization under definitions used in the National Technology Transfer and Advancement Act of 1995. NQF was created by public and private sector leaders in 1999 following the recommendation of the President's Advisory Commission on Consumer Protection and Quality in the Healthcare Industry. It is a recognized leader in promoting patient safety and quality in healthcare.

Executive Director Professor Bryan Liang Briefs Department of Health and Human Services Deputy Secretary on Border Drug Risks

August 8, 2008. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, briefed Deputy Secretary of Health and Human Services Tevi Troy on the issues of counterfeit and tainted drugs associated with the Mexican border. The briefing was part of a bi-national border health visit by the Deputy Secretary arranged by the Border Health Commission, County of San Diego Department of PUblic Health, and Mexican Authorities.

In his briefing, Dr. Liang noted that 40 percent of drugs in Mexico are reported by the World Health Organization to be fake or tainted, and with millions of US citizens going over the border for drugs, this represents a serious health hazard. He also noted that Mexican illicit drug manufacturers are becoming a source for illegal online drug sellers, which represents additional challenges for drug safety in the US.

Professor Bryan A. Liang Discusses Ethics and Professionalism in Audiology

August 4, 2008. The challenges of choosing a business model or professional model in emerging healthcare roles has created competing ethical and legal concerns in the field of audiology. Professor Liang was asked to assist audiologists in parsing the competing models.

Professor Liang noted that "Business ethics require maximizing firm profits while professional ethics focuses on maximizing patient welfare. So selling products is consistent with business, but seeing patients and developing trust with them is a professional ethics concern. Audiology must choose one or the other: business ethics and a focus on profits are inconsistent with professional activities that focus on patients first."

Professor Liang's presentation was entitled "Audiology: Choosing an Ethics Model in an Expanding Legal World, Professional Issues in Audiology," given at San Diego State University.

Executive Director Bryan A. Liang Presents at World Conference on Clinical Pharmacology and Therapeutics

July 30, 2008. Counterfeit drugs and the legal regulatory system internationally has created vulnerabilities in the supply chain. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, presented some of his work on this topic at the IXth World Conference on Clinical Pharmacology and Therapeutics in Quebec City, Quebec, Canada.

"Parallel trade, where pharmaceuticals are traded across borders by cross-border arbitrage agents, and the Internet create real problems for regulators who are trying to ensure safety of the drug supply," Professor Liang noted. "These challenges are mounting as the supply and manufacture of drugs becomes a global enterprise, and governments are left behind in attempting to use 20th century legal methods to address 21st century problems."

The presentation was entitled, "Parallel Trade in Pharmaceuticals: The Risks of Counterfeit Drugs."

New Haven Register Publishes Professor Bryan A. Liang's Op Ed on Tax Credits and Biologics

July 29, 2008. Presidential candidate Barack Obama has proposed a $6 billion plan to provide tax credits to small businesses to encourage them to offer health insurance. He has indicated that this can be paid for by biologic drug savings through introducing "generic forms."

Professor Bryan A. Liang, an expert on the topic, indicated that although increasing access to drugs is an essential aspect of any health reform, biologics are not akin to small molecule pills that are easily made into generics. He noted that immune and other adverse drug reactions are difficult to predict and that large biologics have unique concerns that require attention before "follow on" forms can be introduced into patient care.

The op ed is "Biologics require unique regulation," published in the July 29, 2008 edition of the New Haven Register, on page A8.

Los Angeles Daily Journal Quotes Professor Bryan A. Liang on Illegal Health Policy Rescissions

July 28, 2008. The continuing saga of California's efforts to address the harms associated with illegal health insurance policy rescissions continues. The Los Angeles Daily Journal interviewed Professor Bryan A. Liang on his thoughts regarding the recent developments in the state's efforts.

Professor Liang noted that the recent settlements were a "tie" between consumers and the insurers. He added that although the consumers do get reinstatement of their policies, the standards by which their grievances for illegal rescission in arbitration are not well defined, and that it will be lawyers and former judges who act as the arbitrators, and no consumer representatives will be included.

The story is "State Closes Book on Illegal Policy Rescissions," by Evan George on page 1 of the July 28, 2008 edition of the Los Angeles Daily Journal.

Southern California Public Radio Interviews Professor Bryan A. Liang on New Rescission Lawsuit

July 17, 2008. As the health insurance debate heats up, new charges have been filed by Los Angeles City Attorney Rocky Delgadillo against Blue Shield for illegal policy rescissions. National Public Radio affiliate KPCC interviewed Professor Bryan Liang, a noted expert, for his reactions.

Professor Liang noted that he admired the City Attorney’s stance, and hoped it would be the basis of future accountability for health insurers in the individual market. He also indicated that the legal rules already exist, and the key is to have appropriate enforcement to stop these insurer actions.

The story is "L.A. City Attorney Files Complaint Against Blue Shield," KPCC Southern California Public Radio, by Frank Stoltze.

El Bohemio Publishes Op Ed on Biologics by Bryan A. Liang

July 16, 2008. The debate on regulation of biologic drugs and their "follow on" forms has heated up in Congress. Minorities and other vulnerable patient populations will be disproportionately impacted by decisions in this area. El Bohemio published Professor Bryan Liang's comments on the topic.

Professor Liang noted that biologics such as injectable cancer drugs are different than standard pills, and can induce unforseen immune reactions. He called for US policymakers to learn the lessons of other countries in regulating these drugs to ensure patient safety.

The op ed is Aviones de juguete y medicamentos complicados, in the July 16, 2008 issue of El Bohemio.

Capitol Weekly Interviews Professor Bryan Liang on ePedigree Developments

July 10, 2008. California's e-pedigree efforts to ensure safety of the drug supply continue to develop. With competing bills offering either limited coverage of entities subject to the rule or establishing a task force to study additional issues, Capitol Weekly interviewed noted expert Professor Bryan Liang for his perspective.

Professor Liang noted that these efforts undermined important efforts to promote safety. He also added tha that they represented more delaying tactics rather than a substantive means to find the best means to regulate the drug supply.

The story is "Administration, Ridley-Thomas Duel Over Drug Safety," by Malcolm Maclachlan, in the July 10 issue of Capitol Weekly.

Professor Bryan A. Liang's Opinion Piece on College Health Programs Published in University Business

July 1, 2008. With increasing evidence that lack of health insurance is affected younger, college-aged populations, the implications for students and their families is growing. University Business published Professor Bryan A. Liang's op ed on this important issue.

Professor Liang noted that most college health programs are either limited and require large co-payments, or are redundant to health insurance students already have through their family plans. He indicated that colleges and universities should much more aggressively shop for health care plans that provide better coverage for this desirable population, and let students use family health insurance that already cover health care costs instead of forcing students to buy poor coverage from schools.

The piece is "Ailing College Health Program: Cures for college-sponsored program woes," on page 80 of the July 2008 edition of University Business.

Executive Director Bryan A. Liang Quoted in Story on Third Party Administrator Liability

June 30, 2008. The insurance market continues to develop and questions regarding insurance company liability for administering health plans have arisen. In anticipation of a lawsuit addressing this issue, the Los Angeles Daily Journal interviewed Professor Bryan Liang on the topic.

Professor Liang noted that insurers acting as third party administrators of health plans have faced liability in other jurisdictions. He indicated that believed that the California courts would take such claims seriously when evaluating the issue, particularly because these administrators do receive financial benefits from denying claims.

The story is "Dead Judge's Lawsuit Raises Insurance Liability Issues," by Evan George, on page 1 of the June 30, 2008 issue of the Los Angeles Daily Journal.

Professor Bryan A. Liang Quoted in Los Angeles Daily Journal Rescission Case Story

JUne 17, 2008. In a closely watched case, the family of a patient with anorexia who committed suicide after being discharged by a hospital in a claimed insurance rescission will soon go to trial. The Los Angeles Daily Journal asked Professor Bryan Liang, a noted expert in this area, for his observations.

Professor Liang noted that the disputed factual matters of the case in combination with claims that eating disorders are not within "medical necessity" coverage cloud the impact of the case for policy purposes. He indicated that mental health parity legislation would address at least some of the concerns arising from the case.

The story is "Case Will Probe Coverage for Anorexia," by Evan George, on page 1 of the June 17, 2008 issue of the Los Angeles Daily Journal.

Los Angeles Daily Journal Publishes Op Ed by Professor Bryan A. Liang on Rescission Settlements

June 5, 2008. The announcement of California Department of Managed Health Care settlements with two major insurers in rescission cases has garnered significant attention. However, challenges still exist.

Professor Bryan Liang published an op ed in the Los Angeles Daily Journal indicating that although a good start, issues remain. He observed that there continue to be no provisions for mandated third party review of rescissions, no limits on reinstated patient premiums, an arbitration process unfamiliar to patients, a difficult process for proving damages, and no change in rescission review. Hence, he concluded that the system still puts the onus of inappropriate insurer practices upon vulnerable patients.

The op ed is "No Patience for Patient Care," on page 6 of the June 5, 2008 issue of the Los Angeles Daily Journal.

Professor Bryan A. Liang Interviewed for County TV Program on Advance Directives

June 4, 2008. With the increasing challenges of limited use of advanced directives, San Diego County Aging and Independent Services has produced an educational TV program on the topic. County TV interviewed Professor Bryan Liang on the legal and medical issues of advanced directives.

Professor Liang, who is both an attorney and a physician, indicated that advance directives were important not only as an issue of patient autonomy, but also as a community resource concern since patients obtaining unwanted treatment in the absence of a directive may preclude others from receiving the benefits of medical care. He also stressed that professionals involved in advance directives be sensitive to cultural differences in discussing and implementing these directives.

The program will air on a future program on the San Diego County TV Network.

Bryan A. Liang Quoted in Los Angeles Daily Journal Article on Surgery Center Licensure

May 23, 2008. The California case of Capen v. Shewry has resulted in the Department of Health no longer issuing licenses to physician-owned ambulatory surgical centers. This has created confusion on how these facilities can still operate. The Los Angeles Daily Journal asked Professor Bryan Liang to explain.

Professor Liang noted that these systems could still operate if they are accredited by ambulatory surgery center accreditation agencies, or are certified by Medicare. However, issues remain as public and private insurers often mandate licensure for eligibility for payment. He indicated that the California legislature is current considering a legislative clarification on this issue.

The story is "Licensing Snafu Places Some Surgery Centers in Legal Limbo," by Evan George on page 1 of the May 23, 2008 issue of the Los Angeles Daily Journal.

Executive Director Bryan A. Liang Interviewed by KCBS on Health Insurance Rescission Settlement

May 16, 2008. With the recent settlement announcement regarding wrongful insurer rescissions of individual health insurance policies, KCBS radio interviewed Professor Bryan Liang on its implications.

Professor Liang noted that the settlement was a positive step, but still required patients to prove they are entitled to coverage rather than having the insurer prove they appropriately rescinded the policy. He indicated that the settlement represented a good first step but additional reforms are needed.

Professor Bryan A. Liang Gives Bioethics Presentation at Naval Medical Center

May 12, 2008. Law is an integral part of addressing bioethics dilemmas in health care. This is particularly true in challenging circumstances involving wounded warriors and military patients. The Naval Medical Center at Balboa Hospital invited Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, to provide insights into this important matter.

Professor Liang noted that critical issues in law and health care often surround three different but related areas: informed consent, patient privacy, and end-of-life circumstances. He discussed the "legal voice" in these areas coupled with the ethical obligations of health care providers. "Through an understanding of law in the context of our health care ethics," he noted, "we are in the best position to advocate for our patients as well as understand our accompanying legal obligations relating directly to care."

Professor Liang was invited by Lt. Commander Chris Stafford to present to the committee. The Navy Medical Center of San Diego at Balboa Hospital is one of the largest military service centers in the US and is a primary site for wounded warrior care.

Executive Director Professor Bryan A. Liang Quoted in Business Week Story on College Health

May 9, 2008. The increasing burden of health insurance is affected college students. However, the college health programs may be extremely limited in coverage. Business Week interviewed Professor Bryan A. Liang on the topic.

Professor Liang noted that college and university students represent 10% of the uninsured in the US. But because of their status, they and their families are captive to the only insurance available to them in the college health system. Hence, insurers can be extremely limited in their coverage in these programs.

The story is "Is Your Kid Covered? Insurers make big profits from college students, but some families are left with huge bills," by Ben Elgin & Jessica Silver-Greenberg, in the May 8, 2008 edition of Business Week.

Professor Bryan A. Liang Comments on Drug Safety in Omaha World-Herald Op Ed

May 8, 2008. With increasing attention to the dangers of foreign-sourced drugs as represented by the heparin case, the Omaha World-Herald published Professor Bryan Liang’s opinion editorial on the topic.

Professor Liang noted that foreign-sourced drugs from high risk countries like China will only increase, as it is the number one exporter of active pharmaceutical ingredient in the world. He indicated that the heparin case is a watershed event and warning as to the vulnerabilities of the drug supply. He called for the FDA and US Congress to act to ensure safety of drugs for patients in this country.

The op ed is "U.S. Dares Not Assume Foreign Drugs Are Safe," in the May 8, 2008 issue of the Omaha World-Herald, page 7B.

Dr. Bryan A. Liang Serves as Reviewer for Controversial Recommendations on Disaster Resource Allocation

May 6, 2008. The realities of limited resource allocations for critically ill patients requires a decisionmaking process on who may live and who may die. The American College of Chest Physicians drafted a set of controversial guidelines and recommendations on the topic. Dr. Bryan Liang, Executive Director of the Institute of Health Law Studies was the primary reviewer of the recommendations. In addition to being the Executive Director of the Institute of Health Law Studies, he is also a member of the Center for Emergency Preparedness and Response, Graduate School of Public Health at San Diego State University, and Co-Director of the San Diego Center for Patient Safety, University of California San Diego School of medicine.

The report is "Definitive Care for the Critically Ill During a Disaster: A Framework for Allocation of Scarce Resources in Mass Critical Care," available here.

Professor Bryan A. Liang Publishes Op Ed in Los Angeles Times on Follow On Biologics

April 28, 2008. Calls for follow on forms of biotech drugs are being debated, with Congressional proposals to allow abbreviated review of these “follow on biologics.” However, as Professor Bryan Liang notes in his op ed piece, unique safety issues are presented by biologic drugs.

Professor Liang called for a regulatory scheme that follow the lessons of the European Union, which requires clinical testing of these drugs for safety purposes. Because of the complexity of these drugs, the limited scientific means by which to characterize them, and the potential for severe adverse reactions, he emphasized that follow on forms are substantive different from "small molecule" drugs like the pills we obtain from our local pharmacy.

The op ed is "Don't Compromise the Safety of Biotech Drugs" in the April 28, 2008 issue of the Los Angeles Times, and is available here.

Executive Director Professor Bryan A. Liang Gives Keynote Address at Hemophilia Leadership Forum

April 24, 2008. Executive Director Professor Bryan A. Liang gave the keynote address at the Bias Hemophilia Leadership Forum in Carefree, Arizona on conflict of interest issues in the hemophilia community.

Dr. Liang noted that "hemophilia is a unique disease because it's treatment is known, reliable, but very, very expensive. With blood factor costs in the millions of dollars for each patient, there is a tremendous financial incentive to influence choice." But Dr. Liang also noted that "the hemophilia community cannot continue to rely on drug companies to subsidize their activities. They must broader their base to ensure that they are not beholden to pharmaceutical company whims."

Dr. Liang also facilitated discussions about different conflict of interest scenarios. He was invited to participate in the Leadership Forum by Val Bias, President and CEO of the National Hemophilia Foundation.

San Jose Foothill Family Community Clinic and Community Clinic Health Partnership Hosts Presentation by Executive Director Bryan A. Liang

April 21, 2008. The San Jose Family Community Clinic and Community Clinic Health Partnership hosted a presentation by Executive Director Professor Bryan A. Liang on the safety of the drug supply and California's efforts in this area.

"We have significant weaknesses in our drug supply, particularly the gray market of medication sales, and of course the Internet," he noted. "But California's efforts to simply track and trace drugs using e-pedigree represents only the start of addressing this issue, not the end. We need to ban Internet sales of drugs unless these sellers are willing to undergo rigorous accreditation, and penalize credit card companies that promote these sales without a prescirption," he added.

The presentation was " Drug Supply Safety and Counterfeit Drugs: Standards of Reform," hosted by the San Jose Foothill Family Community Clinic and Community Health Partnership, in Santa Clara, CA.

Law360 Quotes Professor Bryan A. Liang on Congressional Import Safety Reform Proposal

April 18, 2008. In the wake of identified food and import safety issues, Congress has proposed legislation to identify country of origin of products to promote accountability. Law360 interviewed Professor Bryan Liang for his perspective.

Professor Liang indicated that the proposal will have little impact on safety, and would be easily circumvented. Attention to local inspections is necessary to ensure safety of those products shipped into this country, he noted.

The story is "House Democrats Propose Drug Import Reforms," by Jackie Bell, published in the Health Law and Product Liability sections of Law360. Law 360 is an online news source for cutting edge legal issues for practitioners and policymakers.

Professor Bryan A. Liang Gives Presentation on Safety of Drugs at Latino Diabetes Association Event

April 18, 2008. The safety of the drug supply in California and around the country is particularly important for minorities and other vulnerable populations such as the elderly. Professor Bryan A. Liang was asked to provide information to a wide array of clinical and service staff who serve the minority populations regarding the issues surrounding the weaknesses of the drug supply.

Professor Liang indicated that "the risk of drug supply policy falls upon the most vulnerable patient populations, including minorities, those on fixed incomes, and the elderly." He explained that "the system has moved from gray market drugs through to the Internet. To protect patients, we must ban Internet sales unless these sellers are licensed to practice pharmacy in this state and are subject to rigorous accreditation standards."

Professor Liang's presentation was entitled, "Where'd That Come From? Issues of Pedigree and Counterfeit Drugs," presented at the Latino Diabetes Association California Partnership for Access to Treatment in Montebello, CA.

Executive Director Professor Bryan A. Liang Quoted in AP International Herald Tribune Heparin Story

April 11, 2008. More information has arisen regarding tainted heparin around the world. China has announced efforts to address the issue from its own regulatory system. The Associated Press interviewed Professor Bryan Liang for a story published in the International Herald Tribune on the impact of these efforts.

Professor Liang indicated that the heparin case is likely just the beginning with the Asianization of drug sources. Without attention to the increasing amount of sourcing of drugs from suspect countries, he indicated the problem will grow.

The story is "What went wrong? Heparin probe highlights challenges of regulating global drugs market," in the April 11, 2008 edition of the International Herald Tribune.

Professor Bryan A. Liang Publishes Op Ed in Los Angeles Daily Journal on Foreign Drug Safety

April 3, 2008. With the increasing number of patients reported harmed from tainted heparin from China, the Los Angeles Daily Journal published an op ed by Professor Bryan Liang on the topic.

Professor Liang noted that strict oversight is essential to ensure the safety of offshore manufactured drugs. He proposed that import alerts be placed upon any drugs coming in from high risk countries such as China. If these countries allow FDA offices and inspections on their soil, Professor Liang indicated that import alerts could be cancelled.

The op ed is "Import Alert: U.S. Needs Strict Oversight of Foreign-Made Drugs" in the April 3, 2008 issue of the Los Angeles Daily Journal.

Executive Director Bryan A. Liang Gives Presentation on Counterfeit Drugs with National Industry Leaders

March 31, 2008. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, gave his presentation "Issues of Patient Safety: The Dangers of Counterfeit Drugs," at the national industry event, "Counterfeit Pharmaceuticals: The Scope and Effect of the Epidemic." Professor Liang was joined by Billy Tauzin, President and CEO of the Pharmaceutical Research and Manufacturers of America, and Brad Huther, Senior Coordinator of Anti-Counterfeiting and Piracy, US Chamber of Commerce Global Intellectual Property Center.

Professor Liang is a noted expert on patient safety and the challenges of maintaining the security of the medication supply chain. He serves on the Board of Directors and is Vice President of the Partnership for Safe Medicines, a collaborative of academic, patient, and industry representatives who have policies and programs to promote safety of the drug supply system.

Institute of Health Law Studies Hosts 4th Annual San Diego Health Policy Conference

March 28, 2008. The Institute of Health Law Studies hosted the 4th Annual San Diego Health Policy Conference, entitled "Legal and Medical Issues in Disasters and Emergencies." The event was convened at the Hilton Harbor Island hotel in San Diego.

The event brought together domestic and international legal, law enforcement, medical, military, and provider groups to share perspectives and knowledge on preparing for and addressing disasters and emergencies in our communities. Presentations at the conference included those by Thomas Kubic of the Pharmaceutical Security Institute and former senior executive of the FBI, Bryan A. Liang, MD, PhD, JD, Institute of Health Law Studies, Joya Raha, Institute of Health Law Studies, Adam Dorin, MD, MBA, SHARP Grossmont Hospital, Captain Denny Amundson, MD, US Navy, and James Class, PhD, PhRMA.

The papers from the conference will be published in an upcoming forum. The San Diego Health Policy Conference is an annual event that addresses key issues in the health policy community.

San Luis Obispo Tribune Interviews Executive Director Bryan A. Liang on Transplant Surgeon Abuse Case

March 23, 2008. The criminal trial of transplant surgeon Hootan Roozrokh for dependent adult abuse in attempting to obtain patient Ruben Navarro’s organs has attracted national attention. The San Luis Obispo Tribune interviewed Professor Bryan Liang on his thoughts onthe case.

Professor Liang noted that criminal negligence would have to be proven in the case, and that the prosecution would have an uphill battle in attempting to portray potential medical malpractice as dependent adult abuse. He indicated that policy concerns would require a high burden of proof for the prosecution to obtain a conviction.

The story is "Transplant case to get even more scrutiny," by Sarah Arnquist in the March 23, 2008 Sunday San Luis Obispo Tribune, and is available here.

Professor Bryan A. Liang Discusses Patent Law Reform in Op Ed for Providence Journal

March 22, 2008. Patent law reform has been on the Congressional agenda, with advocates on tightening and loosening requirements pushing their agendas. Professor Bryan Liang, in an op ed in the Providence Journal, argues that applying patent reform for consumer goods is inappropriate for medications.

Dr. Liang notes that although damages for a patent violation for a hinge in a car should be based on the hinge's value, and not the value of the entire car, such a simple paradigm in completely inappropriate for medicines. He argues that the contribution of each patent for a drug is not so easily discerned, and hence allocating damages on the purported "value" of each patent would be impossible.

The op ed is "Drugs aren't cell phones" in the March 22, 2008 issue of the Providence Journal and is available here.

Executive Director Bryan A. Liang Interviewed on E-Pedigree in Sacramento Business Journal

March 21, 2008. The challenges associated with the looming California e-pedigree requirements have raised issues of what the standard will be and consumer concerns. The Sacramento Business Journal interviewed Professor Bryan Liang on these issues.

Dr. Liang indicated that there were unresolved problems associated with the state Board of Pharmacy requirements. He noted that the technological standards were only vaguely outlined. He also pointed out that patient privacy concerns would need to be addressed.

The article is "Pharmaceutical fighting: State mulls another delay in deadline for new electronic system to reduce counterfeit drugs," by Kathy Robertson in the March 21, 2008 issue of the Sacramento Business Journal.

Capitol Weekly Publishes Executive Director Bryan A. Liang's Op Ed on E-Pedigree

March 20, 2008. The drawing deadline for the California e-pedigree law is approaching and attention is focused on its implementation. Capitol Weekly published an op ed by Professor Bryan Liang on this topic.

Professor Liang noted that although a good law, key technology issues have still not been addressed, and the costs of ineffective implementation will fall on the consumer. He indicated that the Board of Pharmacy should delay the bill's implementation until 2011, and he called upon the legislature to address the key problem of Internet drug sales in the interim.

The op ed is entitled "Protection against counterfeit drugs too important to rush," in the March 20, 2008 edition of Capitol Weekly, and is available here.

Professor Bryan A. Liang Gives Lecture on Healthcare Contracting in UCSD Core Lecture Series

March 19, 2008. Professor Bryan A. Liang, both a physician and an attorney, gave the presentation, "Issues in Healthcare Contracting: Some Issues Above the Dotted Line" in the University of California San Diego Medical Center and School of Medicine Resident Core Lecture Series. His presentation was held at the Hillcrest Medical Center as well as video transmitted to the VA Medical Center, La Jolla.

In his lecture, Professor Liang noted that healthcare contracting particularly for employment services is very challenging. His focus was on the three stages of contracting and negotiation: due diligence, internal and external party analysis, and contracting terms. He urged the audience to be partners in their contract efforts and work with attorneys to ensure a complete understanding of the agreement.

The UCSD Medical Center hosts the Resident Core Lecture each month. For more information, check the Graduate Medical Education website here.

Executive Director Bryan A. Liang Publishes Op Ed on China Counterfeits in New Hampshire Union Leader

March 14, 2008. The spectre of counterfeits and poor quality drugs from China has been highlighted by the recent heparin case, where dozens of adverse events and 19 deaths from heparin sourced from China have led to recalls in three countries. Professor Bryan A. Liang, Executive Director of the Institue of Health Law Studies, published an op ed in the New Hampshire Union Leader on potential reform.

Professor Liang indicated that China must change its regulatory structure to address poor quality and counterfeit drug production, including adjusting penalties to fit the crime. He also noted that the FDA in the US should issue import alerts on all Chinese drug products until China agrees to an FDA office and inspections in China similar to regulatory functions the agency has here.

The op ed is "How to crack down on counterfeit drugs from China" in the March 14, 2008 edition of the New Hampshire Union Leader, available here.

Professor Bryan Liang Interviewed on E-Pedigree in Healthcare Packaging Magazine

March 13, 2008. The impeding deadline for e-pedigree drug tracking systems has created pressure on packagers and providers who must implement the law. Healthcare Packaging interviewed Professor Bryan Liang on the topic.

Profressor Liang noted that although a good law, technological hurdles still exist to create an effective e-pedigree system. Further, he noted that costs may be disproportionately be placed on pharmacies in communities with vulnerable patient populations. He indicated that these issues must be addressed to ensure that the goals of e-pedigree are accomplished.

The story is "Time for an E-Pedigree System for Packaged Drugs," by Eric Greenberg, available here.

San Luis Obispo Tribune Quotes Professor Bryan A. Liang on Insurance Rescission Case

March 10, 2008. Wrongful insurance company rescissions of individual policies have tremendous negative impact on patients. Recently, a Morro Bay patient’s suit for this practice has been granted class action status by a California court. The San Luis Obispo Tribune asked Professor Bryan Liang on his perspective in the case.

Profesor Liang indicated that this is the second patient suit that has been granted class action for these kinds of insurer’s abuses. Professor Liang also said he believes this development is important to hold insurers accountable for major problems in their underwriting practices.

The story is "Local suit over insurance widens; others can now join Morro Bay woman's legal challenge of Blue Shield cancellation" by Sarah Arnquist in the March 10, 2008 edition of the San Luis Obispo Tribune.

Research by Professor Bryan A. Liang a Featured Article and Early Release in the Annals of Emergency Medicine

February 25, 2008. A highly controversial issue is the use of the clotbusting drug tissue plasminogen activator in stroke patients presenting to the emergency department. Professor Bryan Liang's work to be published on the empirical characteristics of litigation involving this drug was a Featured Article and Early Release of the Annals of Emergency Medicine.

Professor Liang's research showed that the common perception that most litigation stems from adverse effects of the drug rather than not providing it is incorrect. In fact, most lawsuits involve patients claiming they should have been given the drug, rather than stemming from injuries associated with the clotbuster itself.

The article is "Empirical Characteristics of Litigation Involving Tissue Plasminogen Activator in Ischemic Stroke," forthcoming in the Annals of Emergency Medicine. The Annals of Emergency Medicine is the top ranked journal in the field of emergency medicine.

Executive Director Bryan A. Liang Gives Keynote Address at Wake Forest University Symposium

February 22, 2008. Executive Director Professor Bryan A. Liang gave the keynote address at the Wake Forest University School of Law Intellectual Property Journal Symposium. The Symposium was on the topic of counterfeit drugs.

"This is not a theoretical problem with faceless, nameless victims," said Professor Liang, who is also a physician. "These are patients who are your family and mine. The efforts to address this problem have failed to take into account key related aspects of acess to pharmaceuticals--access at a price patients can afford, and access to the legitimate drug. No one gets the benefit of drugs if they are out of reach financially or because they aren't real. We need to take these related aspects into account to address the problem of counterfeit drugs."

Professor Liang's presentation was entitled "A Dose of Reality: Promoting Access to Pharmaceuticals." The paper accompanying his address will be published in the Wake Forest Intellectual Property Law Journal.

The Institute of Health Law Studies Hosts the Institute for Medical Quality CLC Regional Workshop

February 22, 2008. The Institute of Health Law Studies hosted the Institute for Medical Quality CLC Regional Workshop. The Institute for Medical Quality is a subsidiary of the California Medical Association. Each year, IMQ hosts a regional workshop in Northern California and one in Southern California.

It has been several years since there has been an IMQ Regional Workshop in the San Diego area and it is usually hosted by a hospital or medical provider. However, this year, due to IHLS accreditation as a continuing medical education (CME) provider, it was asked to host the CLC Regional Workshop.

California Western School of Law through IHLS is the first and only law school in the nation with the power to grant CME credits to health care providers. The CME program is lead by Executive Director Dr. Bryan Liang and CME Coordinator Pam Tait.

Professor Bryan A. Liang Interviewed by Capitol Weekly on Internet Drug Regulation

February 21, 2008. Awareness of the problems of the Internet as a source of counterfeit and illicit substances is increasing. Capitol Weekly asked Professor Bryan Liang about regulatory efforts in this area.

Professor Liang noted that there is little currently that has emerged to protect patients and prosecute criminals engaged in selling drugs over the Internet. Risks include purchasing fake drugs, or access to dangerous active pharmaceutical ingredients without physician oversight. He emphasized heightened criminal penalties are essential to deter this “Internet drug pushing.”

The story is "Activists fight for regulation of online pharmaceutical sales," by Malcolm Maclaughlin in the February 21, 2008 issue of Capitol Weekly.

Dr. Bryan Liang Addresses UCSD School of Medicine Class of 2008 on Patient Safety

February 19, 2008. Dr. Bryan Liang, Executive Director of the Institute of Health Law Studies and Co-Director of the San Diego Center for Patient Safety addressed the UCSD School of Medicine Class of 2008 on issues regarding patient safety. His focus was the systems and legal interface of mitigating the occurrence of medical errors.

"Errors are inevitable, and as humans, our goal should be to avoid preventable errors. But in addition, we must make our delivery care systems resilient to error occurrence," he noted. "Through using well-established tools from industries such as aviation, we can ensure high quality care and a lower incidence of patient injury."

Dr. Liang also participated in a panel discussion of individual physicians who discussed their own errors and how these errors impacted them personally.

Professor Bryan A. Liang Presents at UCSD Research Ethics Journal Club

February 13, 2008. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, was an invited speaker at the University of California, San Diego Research Ethics Program Journal Club. His topic was "Limited English Proficiency and Health Literacy: Issues for Concern."

"More than 10% of all US counties now have whites as a minority. More than 49% of patients over the age of 65 only reach the National Adult Literary Survey Level I: they cannont fill out a Social Security application nor find two pieces of information within a newspaper article," said Dr. Liang. "This creates tremendous challenges for health care delivery, and implicates our ethical duties toward establishing a research paradigm that takes into account these realities."

Dr. Liang was invited to speak by Michael Kalichman, PhD, Director of the Research Ethics Program at UCSD.

US News & World Report Health Insurance Story Quotes Executive Director Bryan A. Liang

February 11, 2008. Increasing attention to the practices of health insurers has placed access to insurance in the policy forefront in the upcoming Presidential election. US News & World Report interviewed Professor Bryan Liang on the developments of this issue.

Professor Liang indicated that lawsuits that preclude post-claims underwriting--insurers waiting until individual health insurance enrollees claim for health services in excess of policy premiums before assessing the application and then seizing on any omission or inaccuracy to cancel the policy--may signal important changes in the law that protect consumers. With 47 million uninsured citizens in the US who may be seeking individual policies and decreasing employer coverage, additional lawsuits challenging this practice may be forthcoming, he added.

The story is "Health Insurance Options That Squeeze Individuals" by Michelle Andrews in the February 11, 2008 issue of US News & World Report.

Institute of Health Law Studies Sponsors Team in the California Innocence Project Dodge Ball Tournament

February 11, 2008. The Institute of Health Law Studies and Health Law Society sponsored and entered a team of 6 participants to play in the annual California Innocence Project dodge ball tournament. The team, the Health Law Scrubs. wore uniforms of medical scrubs with stethoscopes and masks.

The competition was quite fierce but the team managed to hold their own and come through the competition without any stitches or bruises.The tournament is a fundraiser for CIP, which assists wrongly convicted citizens to establish their innocence in the justice system.

Institute of Health Law Studies Collaborates with Rady Children's Hospital Heart Institute

February 9, 2008. The Institute of Health Law Studies collaborated on its First Annual Rady Children's Hospital Heart Institute Valentine Party collaboration with Rady Hospital.

Pam Tait, IHLS Program Administrator and several Health Law Society students stuffed and handed out over 700 teddy bears and heart bags to attending pediatric heart patients and their families. The heart bags were the donation of IHLS. Proceeds for the event were generated from a bace sale by the Institute and Health Law Society on February 6, 2008 at California Western School of Law.

The Institue of Health Law Studies has initiated several community service projects as part of its mission. This month also marks the Institute's annual "Warm a Heart" clothes drive for the homeless.

Pharmawire Article on RiskMAPs Quotes Professor Bryan A. Liang

February 5, 2008. The debate on the drug Entereg and its potential use has centered upon an FDA risk minimization action plan or RiskMAP. Pharmawire interviewed Professor Bryan Liang on the implications of this current debate.

Professor Liang indicated that RiskMAPs will likely become more common conditions for approval because of the safety issue focus of the FDA. In addition, because of the use of drugs outside of their approved profile, known as "off-label" use, the FDA may be seeking additional control over the settings that are considered appropriate for drug use. Finally, he added, these RiskMAPs may have their use extended to reimbursement decisions.

The article is "Adolor's Entereg could be latest FDA approval with RiskMAP; expectations for many more to come - analysis," by Aaron Lorenzo in the February 5, 2008 issue of Pharmawire.

Institute of Health Law Studies and Health Law Society Hold Blood Drive

February 5, 2008. The Institute of Health Law Studies and the Health Law Society held its annual Red Cross Blood Drive today in the 350 Building at California Western School of Law. Almost 30 pints of blood were collected from members of the California Western School of Law and local communities.

"This is a critical effort to improve the health and emergency preparedness of San Diego," said Executive Director of the Institute of Health Law Studies Professor Bryan Liang. "The blood collected during the drive is truly the gift of life for those in need."

San Diego Business Journal Interviews Executive Director Bryan A. Liang on California ePedigree

February 4, 2008. The debate on epedigree requirements for drug tracking in California has intensified as the January 1, 2009 deadline approaches. The San Diego Business Journal asked Professor Bryan Liang for his perspective on this issue.

Professor Liang noted that approaches that focus on tracking the drug, rather than just the packing are necessary. Further, he indicated that technology must address interoperability issues for an effective system to be implemented.

The story is "Drug Makers Want to Extend Deadline for Drug Tracking," by Heather Chambers in the February 4, 2008 issue of the San Diego Business Journal.

Professor Bryan A. Liang Honored with University of California San Diego Mentor Recognition Award

February 1, 2008. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, was recognized by Chancellor Marye Anne Fox and Dean of Graduate Studies Kim E. Barrett of the University of California San Diego with the Mentor Recognition Award. Dr. Liang was nominated by Ms. Lori Silberblatt, who is a student in the joint CWSL-UCSD MAS Program in Health Law.

Chancellor Fox and Dean Barrett noted in their recognition of Professor Liang that "Thanks to your dedication, students come to UCSD enthusiastic about facing the future, eager to absorb more knowledge, ready to sharpen their skills, and excited about taking their talents out into the world. ... We salute you. The world is a better place because you took the time to be a mentor." Dr. Liang was honored "in recognition of your commitment and dedication to mentoring students in their preparation for graduate study."

Professor Liang is well known for his activities with students. In 2007, he was given the Outstanding Educator Award by the University of California, San Diego School of Medicine students.

Institute Kicks off "Warm a Heart" Clothes Drive

February 1, 2008. The Institute of Health Law Studies kicked off its 4th annual "Warm a Heart" clothes drive. The project benefits the Alpha Project campaign for the homeless.

As noted by Pam Tait, Institute Program Director, there are over 15,000 homeless men, women and children throughout San Diego County. This time every year, coats, sweatshirts, hats, gloves and blankets are in high demand. The drive will help those most in need.

Items may be dropped off for the entire month of February in the CWSL 350 building lobby in the Warm a Heart box. Any questions, please contact Pam Tait at (619) 515-1568.

Capitol Weekly Article on Single Payer Reform Quotes Professor Bryan Liang

January 31, 2008. The failure of comprehensive health reform in California has spurred advocates for government provided, single payer efforts. Capitol Weekly interviewed Professor Bryan Liang on his perspective of this development.

Professor Liang noted that although single payer methods have benefits, the failure of hybrid methods do not mean there is a mandate for single payer approaches. He noted that countries such as Canada and the UK that use single payer have faced tremendous challenges themselves, and show government sponsored insurance is not a panacea.

The article is "Single-payer or bust?" by Malcolm Maclachlan in the January 31, 2008 issue of Capitol Weekly.

KPBS Radio Interviews Professor Bryan A. Liang on California Health Insurer Regulator Action

January 30, 2008. The announcement that California regulators will be fining Pacificare up to $1.3 billion dollars for wrongful claims practices has garnered significant policy attention. KPBS Radio interviewed Professor Bryan Liang on its implications.

Professor Liang noted that egregious insurer practices have finally started to be the subject of regulator attention and that future investigations will likely occur. This is particularly true in light of court cases and legislative efforts to reign in these practices.

Professor Liang was interviewed by KPBS Radio correspondent Kenny Goldberg.

Professor Bryan Liang Quoted in Business Week Cover Story on Cholesterol Drug Marketing

January 28, 2008. With recently released information showing inappropriate promotion of the benefits of certain cholesterol lowering drugs, Business Week interviewed Professor Bryan Liang on pharmaceutical "detailing," the term for the aggressive sales efforts by sales agents of pharmaceutical drugs.

Dr. Liang noted that the sales of medicines are a huge business, and create incentives to claim larger benefits than warranted. He also noted that such efforts may even convince physicians of the limited benefits of the drug.

The story is "Do Cholesterol Drugs Do Any Good?" by John Carey, in the January 28, 2008 issue of Business Week beginning on page 52.

Capitol Weekly Interviews Professor Bryan Liang on California E-Pedigree Law

January 24, 2008. With the challenges to drug electronic pedigree growing, California legislative observers have been debating the need to implement these requirements by the January 1, 2009 deadline. Capitol Weekly interviewed Professor Bryan Liang on the matter.

Professor Liang indicated that the epedigree effort is illustrative of the challenges in trying to implement a program across widely different stakeholders with divergent interests. Because of these concerns, he notes that there may be justifications in a delay. In particular, Professor Liang notes that differences in the type of product, for example syringes versus chemical pills, create substantively different problems for the effort.

The story is "Pharmaceutical companies trying to push off epedigree deadline" by Malcolm Maclahan in the January 24, 2008 issue of Capitol Weekly.

Professor Bryan A. Liang Gives Presentation on Audiology Professionalism, Law, and Ethics

Janry 23, 2008. Executive Director Professor Bryan A. Liang gave a presentation to the Illinois Academy of Audiology on professionalism, law, and ethics at the organization's Annual Meeting in Chicago.

Professor Liang noted that "with audiology representing a $3-5 billion dollar industry, legal matters such as fraud and abuse as well as conflict of interest laws are of great importance to the field." However, he added that "law is just the lowest common denominator of what should be done in health care provisions. Audiologists will be key providers as the population ages, and must consider whether they will engage in a professionalism model of ethics, or a business model of ethics. Critically, only one can be chosen."

Professor Liang's talk was "Audiology: Choosing An Ethics Model in an Expanding World of Legal Oversight."

San Francisco Chronicle Interviews Professor Bryan Liang on E-Pedigree Law

January 23, 2008. With the January 1, 2009 California deadline for use of electronic pedigree for drugs drawing closer, hearings are being held by the Board of Pharmacy about implementation of e-pedigree. The San Francisco Chronicle interviewed Professor Bryan Liang regarding the issue.

Profesor Liang noted that although a good idea, the actual practicalities of the electronic pedigree for drugs in the state were not well thought out. He added that the law may create access issues for some of the most vulnerable populations if their pharmacies must close because of the inability to meet the requirements of the law.

The story is "Drug-tracking system faces another delay," by Deborah Gage and Victoria Colliver, in the January 23, 2008 issue of the San Francisco Chronicle on page C-3.

Los Angeles Daily Journal Publishes Op Ed by Dr. Bryan Liang on Lethal Injection Case

January 10, 2008. The US Supreme Court heard arguments on January 7, 2008 in the controversial Baze v. Rees case on the constitutionality of lethal injection. Professor Bryan Liang, both a physician and attorney, published an op ed on the medical-legal issues in the case.

Dr. Liang indicated the need for the legal system to come up with legal solutions to this question, rather than relying on the medical community to oversee the process. Because the arguments in the case focus on having physicians participate, Dr. Liang noted that this would violate the primary ethical tent of the profession: "first, do no harm."

The op ed is: "Lethal Considerations," and appeared in the January 10, 2008 Forum section of the Los Angeles Daily Journal.

Institute Executive Director Dr. Bryan A. Liang Interviewed for Pharmawire Vytorin Stories

January 18, 2008. The delay associated with the release of negative clinical trial results for Vytorin has attracted tremendous scrutiny. Pharmawire interviewed Professor Bryan Liang on the implications.

Professor Liang noted that Schering-Plough and Merck officials could face civil and criminal liability as well as Congressional investigation associated with the delay. Dr. Liang added that corporate troubles are also associated with the delay in release of Vytorin data. He noted that both Schering-Plough and Merck will face heavy scrutiny regarding information that was required to be disclosed to shareholders, and the Securities and Exchange Commission may also investigate the action of drug company officials who sold stock during the delay period.

The stories are "Schering-Plough and Merck could face civil suit, criminal penalties asa result of delay in releasing ENHANCE trial data, lawyers say," by Aaron Lorenzo and Beth Herskovits in the January 17, 2008 issue of Pharmawire, and "Schering-Plough and Merck could face investor suits, SEC probe, but have strong defense, lawyers suggest," by Aaron Lorenzo and Beth Herskovits in the January 18, 2008 issue of Pharmawire.

Professor Bryan A. Liang Interviewed By Capitol Weekly on Upcoming Year's Legislative Activities

January 3, 2008. With increasing attention to health care issues in California, Capitol Weekly interviewed Professor Bryan Liang on the upcoming year’s legislative efforts.

Professor Liang noted that the state legislature in the past year focused ondiscrete health insurer abuses, such as health insurer rescission practices addressed by Assemblymember Hector de la Torre's bill (AB 1324). The critical issue of this coming year is comprehensive reform. Dr. Liang indicated that there may be a need to turn back to the more narrow policy strategy if comprehensive reform is stalled in the state.

The story is "While health insurance bill hangs in the balance, new restrictions on providers go into effect," by Malcolm Maclachlan in the January 3, 2008 Capitol Weekly.

LA Times Interviews Professor Bryan Liang on Insurance Rescission Case

December 25, 2007. On an appellate court decision holding that insurers cannot rescind health insurance policies without showing willful representation on the part of the applicant, the Los Angeles Times interviewed noted expert Professor Bryan Liang on the case.

Professor Liang indicated that this was the first California appellate court decision interpreting the law, and noted that the court was clear in stating that current insurer practices are not legal grounds for insurance rescission. He also pointed out that the court's decision was consistent with the interpretation of the law by the California Department of Managed Health Care.

The story is "Court curbs insurers' ability to rescind medical policies," by Lisa Girion of the LA Times.

Executive Director Bryan A. Liang Publishes Op Ed in San Diego Union Tribune on Drug Importation

December 21, 2007. In response to Congressional passage of an omnibus funding bill for the FDA that includes drug importation, the San Diego Union Tribune published an op ed by Professor Bryan Liang on the dangers of this approach.

Professor Liang noted that increased FDA funding is desperately needed, but by adding importation, Congress has created new problems that may drain resources away from bringing safety efforts to an acceptable and effective level. "Additional funding is certainly part of the cure. But by simultaneously introducing importation, Congress has made the cure a toxic mix at best."

The op ed is entitled, "A very real drug importation threat," in the San Diego Union Tribune. It is available here. Professor Liang is also Co-Director of the San Diego Center for Patient Safety at UCSD School of Medicine, and Vice President of the Partnership for Safe Medicines.

Professor Bryan A. Liang Interviewed on KPBS Radio on Post-Claims Underwriting Decision

December 6, 2007. The fallout from the California Appellate Court decision on post-claims underwriting has continued. KPBS Radio asked Professor Bryan Liang his thoughts on the regulatory impact of the decision.

Professor Liang noted that the interpretation of the court was one the Department of Managed Health Care had been stating for some time: that post-claims underwriting is categorically illegal. However, with an appellate court ruling, the DMHC may be able to take a more aggressive stance against the practice.

Kenny Goldberg, KPBS Health Correspondent interviewed Professor Liang. Professor Liang is a regular interviewee on health law and policy issues for a wide array of media outlets.

Dr. Bryan A. Liang Quoted in LA Times Article on California Appellate Decision on Post-Claims Underwriting

December 5, 2007. In the wake of a California Appeals Court decision in Ticcoli v. Blue Shield Life on post-claims underwriting, the L.A. Times asked Professor Bryan Liang to comment upon its implications.

Professor Liang indicated that this decision, the first state appellate court decision on the matter, will open up insurers to a greater number of lawsuits and will provide harmed patients with precedent to support their case. "This appellate court decision may really open the doors to changes in policies by the insurers or a lot more lawsuits," said Professor Liang.

The story is "Ruling on recisions is blow to insurers" by Lisa Girion of the L.A. Times.

AMA Monograph on Medication Reconciliation Edited by Executive Director Bryan A. Liang Published

November 28, 2007. The American Medical Association published the monograph, "The Physician's Role in Medication Reconciliation: Issues, Strategies, and Safety Principles." The monograph is a comprehensive effort at providing guidance to America's physicians in response to the importance and complexity of medication reconciliation. Executive Director Professor Bryan A. Liang was the lead editor and author of the monograph.

"Medication reconciliation across care is an important patient safety concept that influences the quality of care given to patients," noted Dr. Liang. "However, making sense of a patient's medications and resolving conflicts between different sources of information to minimize harm and maximize therapeutic effects is a complex endeavor to perform. Hence, this monograph was created to assist physicians and other members of the health care team to accomplish this important goal."

The monograph is a continuing effort of the AMA's "Making Strides in Safety" Program. It includes a "My Medication Card" for patients to list their medications, vaccinations, physicians, pharmacists, and other important information.

Executive Director Professor Bryan A. Liang Attends US Advisory Committee on Minority Health Meeting

November 27, 2007. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, attended the US Department of Health and Human Services Advisory Committee on Minority Health meeting held in Washington, DC. Dr. Liang is one of 12 committee members drawn from the entire US and US territories with expertise on minority health issues.

The advisory committee advises the Secretary of Health and Human Services on ways to improve the health of racial and ethnic minority populations, and on the development of goals and program activities within the Department.

Health Law Society and Institute of Health Law Studies Participates in Habitat for Humanity Project

November 17, 2007. The Health Law Society and the Institute of Health Law Studies in its continuing commitment to community service participated in Habitat for Humanity service project. This year, students and board members met at the Habitat for Humanity ReStore and assisted to sorting and organizing of donated items for resale to promote the goals and mission of Habitat for Humanity.

The Health Law Society and Institute of Health Law Studies have performed other projects for Habitat for Humanity in the past, including restoration of homes for the needy.

Op Ed on Dangers of Internet Drug Sellers by Executive Director Bryan A. Liang Published in Broward Informer

November 15, 2007. New vulnerabilities have arisen with respect to the US drug supply as outlined by recent Congressional hearings. Professor Bryan Liang, and expert on the topic of the safety of the US drug supply, published an an op-ed for the Broward Informer one of these dangers: the Internet.

Dr. Liang noted that online purchasing of medications is a highly risky activity. He gives examples of the risks and harm of online purchasing, and also provides methods to ensure the safety of where drugs are purchased and whether the Internet web site is a legitimate pharmacy.

The op ed is entitled, "Buying Drugs Online Has Never Been Easier," in the November 15, 2007 Broward Examiner. Because of its timeliness, it was also published in the East Greewich Pendulum and in the Tri-State Media newspapers.

In addition to being the Executive Director of the Institute of Health Law Studies and Co-Director of UCSD's San Diego Center for Patient Safety, Dr. Liang is also the Vice-President of the Partnership for Safe Medicines.

Dr. Bryan A. Liang Gives Law and Medicine Lecture at UCSD

November 6, 2007. Dr. Bryan A. Liang, E. Donald Shapiro Distinguished Professor of Health Law, gave the lecture, "Negligence, Conflict of Interest, and End-of-Life: Regulation of Medical Care" at the UCSD School of Medicine.

"Medical training is challenging. Learning every nerve, artery, vein, bone, and lymph node is a hill we all climb," noted Dr. Liang. "But we also have to have a sense of how the law draws boundaries around clinical care and practice. From beginning of care, informed consent, to accountability for that care, medical malpractice, to being paid for care, fraud and abuse laws, physicians must have a sense of law's rules and constraints to effectively advocate for the patient."

Dr. Liang, a physician and attorney, was invited to give this presentation by Dr. Rusty Kallenberg of UCSD's Department of Preventive and Family Medicine.

Executive Director Bryan A. Liang Gives Patient Safety Fundamentals Lecture at UCSD School of Medicine

October 30, 2007. Institute Executive Director Professor Bryan A. Liang, who is also Co-Director of UCSD's San Diego Center for Patient Safety, addressed the Class of 2010 at the UCSD School of Medicine on the topic of patient safety. His presentation was entitled, "Safety and Systems Learning: Focusing on Fundamentals."

"Patient safety, and the principles of addressing medical errors, are critical in ensuring the right patient gets the right care at the right time," he told the audience. "Learning lessons from aviation, we can avoid errors, but more importantly, make the system resilient to the inevitable errors that will occur because we are human."

Dr. Liang is also a licensed pilot. He was asked to give this lecture by Dr. Rick Kronick, UCSD Department of Preventive and Family Medicine.

Professor Bryan A. Liang Comments on Proposed California Regulations on Insurance Rescission

October 24, 2007. With the increasing scrutiny of health insurance rescissions by insurers, patient advocates have called for California Department of Managed Health Regulations to protect consumers from this practice. With new proposed regulations issued, the L.A. Times asked Professor Bryan Liang to comment.

Professor Liang noted that the new regulations were only a restatement of existing law. He added they would encourage litigation because they did not provide for a resolution of rescission decisions before they are carried out. He called for significant review of the regulations to ensure appropriate patient protections.

The story is, "Regulators aim to curb healthcare rescissions," by Lisa Girion of the L.A. Times.

Bryan A. Liang Named E. Donald Shapiro Distinguished Professor of Health Law

October 11, 2007. Bryan A. Liang, Executive Director of the Institute of Health Law Studies, was named the E. Donald Shapiro Distinguished Professor of Health Law at California Western School of Law. The E. Donald Shapiro Professorship is the first endowed chair at California Western School of Law, and honors E. Donald Shapiro, a pioneer of health law.

Professor Liang, upon the annoucement, stated that "To be honored by my colleagues with this Professorship is wonderful. But to further have my name associated with E. Donald Shapiro gives me an embarassment of riches. It is truly a privilege to be the recipient of this chair."

A reception and dinner featuring E. Donald Shapiro and Professor Liang was held where both provided remarks on the future of health care. As well, Professor Edward A. Dauer and Dean Steven Smith also offered their remarks on the role of health law in contemporary legal education, and the contributions of Donald Shapiro and Professor Liang to the field of health law.

Executive Director Bryan A. Liang Discusses Ethics and Conflict of Interest in Hemophila Centers

October 5, 2007. Public care programs provide health care services to underserved patients. However, their mix of public and private funding create potential conflict of interest issues. Hemophilia treatment centers are participate in important public care programs, and asked Professor Bryan A. Liang for his perspective on conflict of interest in care to hemophilia patients.

"Hemophilia treatment centers provide significant public good to underserved patients," said Professor Liang. "But because of the complex financial arrangements, we have to consider legal issues, personal conflicts, and political influence when determine what action to take in response to potential conflicts of interest."

Professor Liang presented paradigms of assessing legal, personal, and political circumstances that may guide providers. He concluded that "transparency, disclosure, and focusing on alternatives that represent the best interest of the patient will keep us honest."

Professor Liang's presentation was entitled, "Hemophilia Conflicts: Assessing the Borders of Ethical Care in Treatment Centers," at the Advancing Care of Bleeding Disorders conference, Northwestern University Conference Center in Chicago, IL.

Dr. Bryan Liang Presents Information on Medication Reconciliation at The Joint Commission

September 25, 2007. Medication reconciliation across sites for care is a tremendously important and challenging patient safety problem. Confusion about medicines being taken leads to medical errors. The Joint Commission, the accreditation body for most US hospitals, convened an invitation-only summit on the topic to explore solutions to this issue.

"Critically, the focus on improving medication reconciliation must take into account the systems issues associated with patient care, using the lessons from patient safety," said Professor Liang. "Further, we must address the key populations affected: minorities and other vulnerable patients with low English proficiency, as well as seniors with limited literacy skills. These are the patients that are disproportionately impacted by ineffective and inefficient medication reconciliation." Finally, he noted that "the legal system is also watching. Recently, a $3.2 million verdict was handed down because of a medication reconciliation failure. We must do better for the health of our patients and our health care system."

Dr. Liang is Executive Director of the Institute of Health Law Studies, California Western School of Law as well as the Co-Director of the San Diego Center for Patient Safety, University of California, San Diego School of Medicine.

Professor Bryan Liang Featured in "National Chat" on Ethics and Law in Audiology

September 25, 2007. As the population ages, the issues associated with hearing have placed audiology as a health care profession in the forefront. As a developing field, audiologists are being more scrutinized with respect to their ethics as well as comport with legal requirements. Dr. Bryan Liang was asked to be the guest of a "National Chat" on Ethics and Law in Audiology in the University of Florida audiology program.

"Audiology ethics will be governed by the choices of the field in the next 25 years as the needs of the graying America become more apparent," said Dr. Liang. "Audiologists must determine if they will take the business model of sales or the professional model of service as their guidance," he added. "But regardless, the scrutiny of clinical actions implicating conflict of interest by law enforcement bodies will increase. Audiologists must concern themselves with ensuring they do not take financial arrangements at face value, and determine their legality at the very outset."

Dr. Liang was asked by Dr. Robert Traynor, Professor of Audiology at the University of Florida to be the guest in the national chat.

Professor Bryan Liang Joins Lew Kontnik of Amgen in CWSL-UCSD MAS Program Event

September 20, 2007. With increasing globalization and calls for drug importation, the issue of counterfeits and brand protection have become paramount in debates locally to the international sphere. The CWSL-UCSD MAS in Health Law convened a workship program event to explore these issues.

Professor Liang and Mr. Kontnik spoke about the risks of counterfeits and diverted drugs. Mr. Kontnik, the Director of Brand Protection of Amgen, Inc., assessed the problem from a corporate drug manufacturer perspective. Professor Liang took the policymaker and advocate perspective. Both indicated that counterfeiting is a growing problem and that there may be particularly high risks along the border and through the Internet.

Providence Journal Publishes Op-Ed by Professor Bryan Liang on Importation Legislation

September 19, 2007. In response to House passage of a provision to legalize drug importation, and recent issues of safety of consumer products from China, the Providence Journal published an op-ed by Professor Bryan Liang outlining the risks assocaited with the proposed law.

Professor Liang noted that “safe” countries such as Canada and the UK have been subject to counterfeits due to weaknesses in the regulatory regime, and that Internet sales are particularly worrisome. He also noted that despite good faith efforts by the Food and Drug Administration, with problematic imported products from toothpaste to toys, drug imports would be a "prescription for disaster."

The op-ed is "Beware Fake Pills from Abroad," published in the September 19, 2007 issue of the Providence Journal.

Executive Director Bryan A. Liang Serves on AMA Expert Panel on Health Literacy and Patient Safety

September 13, 2007. Tremendous challenges exist with respect to patient safety and patients with low health literacy. Executive Director Professor Bryan A. Liang was asked to serve on an American Medical Association Expert Advisory Panel to issue guidelines on the medical, legal, and ethical aspects of providing care to these patients.

"This work is essential to address the growing number of patients with low health literacy in the US," said Professor Liang. "With up to 50% of seniors having low health literacy, this issue needs attention now and in the forseeable future," he added.

The guidelines are in the AMA Foundation report, "Health Literacy and Patient Safety: Reducing the Risk by Designing a Safer, Shame-Free Health Care Environment."

Professor Bryan Liang Participates in Testing Orion Space Navigation System Simulator

September 7, 2007. With the advancement of space flight and impeding retirement of the NASA space shuttle, NASA is developing the next generation of Orion space craft. Part of this effort is a more effective navigation system. NASA Ames Research Center asked Professor Bryan Liang to participate in testing its new Advanced Caution and Warning System (ACAWS) in simulation to test human factor uses of its different forms. This was based on his interest in simulation in patient safety and his ratings as a instrument rated, high performance, complex aircraft pilot.

"Simulation is a great tool for advancement in understanding how and when certain components act well or not with humans," Professor Liang stated. "These human factors are critical to take into account in high risk, intensive operations such as space exploration and medicine."

Testing was performed at NASA Ames Research Center in Mountainview, CA. The results will be used to improve ACAWS before intergration into the Orion spacecraft.

KPBS Interviews Professor Bryan Liang on Delayed Managed Care Regulations

September 4, 2007. When Blue Cross of California was exposed as illegally canceling individual health insurance policies in California, the state Department of Managed Health Care indicated it would act by issuing regulations within 6 months. However, the agency has not done so. KPBS Radio interviewed Professor Bryan Liang for his thoughts on the delay.

Professor Liang noted that the issue was much more complex than initially understood, and the Department took on too much by promising regulations so quickly. The scope of the problem and the varying stakeholders--policyholders, as well as providers and the state legislature--requires a much more thorough review than originally contemplated.

The story is, "State Behind Schedule to Regulate Shady HMO Termination Policies," by KPBS reporter Kenny Goldberg.

Executive Director Bryan A. Liang Asked to Comment on Merck Vioxx Litigation

August 30 , 2007. With the Merck Vioxx trials entering into their third year and the remarkable success of the company in defending the suits, CNN Money asked Executive Director Professor Bryan Liang for his comments on Merck’s efforts.

Professor Liang noted that signaling the litigants and their attorneys early and clearly of the commitment to fight all claims and appealing all losses was a brilliant strategy from a business perspective, and has resulted in not a single dollar being paid out yet to litigants. He added that Merck, as a repeat player, is much better able to defend itself than individual plaintiffs are able to litigate against the company in these trials.

The story is "Merck's Post-Vioxx Comeback," by Aaron Smith, CNN Money Reporter, and is available here.

Healthcare Packaging World Interviews Dr. Bryan Liang on Means to Ensure Safety of the Drug Supply

August 2, 2007. With the increasing scrutiny of the safety of the world drug supply, healthcare packagers are entering center stage for solutions. Healthcare Packaging interviewed Professor Bryan Liang about the key issues and areas that need focus.

Professor Liang indicated that packaging will need to adopt technologies, communication channels, and a broad set of strategies to keep ahead of sophisticated counterfeiters. He noted that to fundamentally address the problems that plague the world's drug supply, all members of the distribution chain must be involved. He also stressed that one solution will not be enough to reach the goal of drug supply safety; because the problem is multi-factoral, the solution must also be.

The intereview is "Diverse approach counters counterfeiting", August 2, 2007, in Healthcare Packaging World.

Quarantine Point-Counterpoint Features Comments by Professor Bryan A. Liang

August 1 , 2007. The debate over TB patient Andrew Speaker case and quarantine has attracted worldwide attention. Atlanta Life Magazine asked Professor Bryan Liang to participate in a point-counterpoint of potential quarantine rules.

Professor Liang noted that quarantine rules have been used for discriminatory purposes in the past, particularly against Asians. However, the current rules would not be a form of imprisonment, and would allow rapid contact of exposed individuals using public health workers, not law enforcement personnel. With globalization, it is critical to be able to quickly contact exposed persons to protect the public health.

The point-counterpoint appears in the August Issue of Atlanta Life Magazine.

Professor Bryan A. Liang Testifies on Declaratory Legislation Before the California Senate Judiciary Committee

July 10, 2007. The California Legislature is considering decarlatory legislation to regulate health insurance practices. It asked Professor Bryan A. Liang to provide insights as to the ramifications of such legislation.

Professor Liang noted that "declaratory legislation is important, including examples such as civil rights legislation. It provides notice to the regulated, the polity, the courts, and regulators of the intended legislative intent, promotes judicial and agency efficiency, and ensures that courts do not assume that because the legislature has amended a statute, protections therein did not exist in the original law."

Professor Liang was testifying in the context of AB 1324, a bill to restate existing laws with respect to insurance company policy rescissions and provider payments.

Los Angeles Times Quotes Executive Director Bryan A. Liang on Department of Insurance Study

July 3, 2007. With the release of a second State of California agency’s report on inappropriate post-claims underwriting by Blue Cross, the Los Angeles Times asked noted expert on the issue, Professor Bryan Liang for his comments.

Professor Liang noted that the new Department of Insurance report on Blue Cross’ practices reinforces the need for regulators to aggressively pursue action to prevent further harm. "We've gotten verficiation from another department doing its own investigation that [post-claims underwriting] is happening consistently," he said. "Clearly the system is broken .... Patients are getting harmed left and right, and nothing is getting done."

The story is "Health insurer cited in policy cancellations," in the Los Angeles Times by Lisa Girion.

Erizen Sei Bowles "Feed A Friend" Drive Begins at IHLS

July 1, 2007. The Erizen Sei Bowles "Feed A Friend" Drive begins today. The food drive, an annual event organized by the Institute of Health Law Studies, is in collaboration with the Health Law Society and the Alpha Project for the Homeless. All packaged and canned foods are accepted and will benefit the Alpha Project shelters and programs. The food drive is named after Erizen Sei Bowles, a former Health Law Society President with a particular interest in the plight of the homeless. Mr. Bowles was tragically killed in an accident earlier this year.

The drive continues until the end of the month. This is the third consecutive year of the drive. For more information, contact Pam Tait, Executive Assistant of the Institute of Health Law Studies.

Managed Care Magazine Quotes Professor Bryan A. Liang on Health Insurance Rescission

June 30, 2007. The managed care industry has become increasingly exposed to insurance company regulators due to inappropriate rescissions. Managed Care magazine interviewed Professor Bryan Liang, a noted expert on the issue for his perspective.

Professor Liang indicated that this problem is not going to go away. With increasing government attention, managed care organizations must pay attention to this issue. He added that with the increasing level of the middle class within the individual insurance markets, scrutiny of insurer practices is likely to grow.

The article is "Plans Under Attack For Use of Rescission" in the June 2007 of Managed Care Magazine, by John Carroll.

Institute Hosts San Diego Continuing Medical Education Coordinators Meeting

June 13, 2007. The Institute of Health Law Studies hosted the San Diego Continuing Medical Educators Coordinators Meeting, held at the University Club in San Diego. The Institute has a strong leadership presence in the CME community. Pam Tait, Executive Assistant of the Institute, is an official CME Mentor as appointed by the Institute of Medical Quality, and the Institute is the only legal program in the United States empowered to grant continuing medical education credit.

As part of the meeting, Professor Bryan A. Liang announced that the Institute is participating in a Robert Wood Johnson Foundation funded project on cultural sensitivity, and provided information on this important health care issue and the project itself. A future meeting will discuss San Diego hospital participation.

Professor Bryan A. Liang Gives Testimony to the President's Commission on Care for America's Returning Wounded Warriors

May 25, 2007. In light of the problems with health care for returning wounded warriors at Walter Reed Medical Center, the President established the Commission on Care for America's Returning Wounded Warriors to investigate the care system and provide recommendations to improve the care provided to these soldiers. IHLS Executive Director Professor Bryan A. Liang was asked to provide his insights on the issues involved.

"The primary and core concern is systems failure in the case management of these service men and women," noted Dr. Liang. "Critically, there needs to be a better understanding of workload of case managers, standardization of services rather than ad hoc measures used now, and measurement of outcomes with respect to case management interventions. In the patient safety and public health arenas, we have learned these lessons, and they can be applied effectively to benefit service provision to these soldiers who have been wounded in action."

The Commissioners will collate information and then create a final document summarizing their findings. That report will be presented to the President.

Executive Director Bryan A. Liang Interviewed on CBS Evening News Special Report on Individual Health Insurance

May 23 , 2007. CBS Evening News conducted a two month investigation on the individual health insurance market and the potential abuses of the system by health insurers. As part of its story, it interviewed Executive Director Professor Bryan Liang on the inability of most persons to obtain individual health insurance policies.

Professor Liang described the database of private information available to insurers and how insurers are attempting to only underwrite policyholders with no risk. He also noted that insurers will look at credit reports and even interview neighbors and colleagues of the applicant. Professor Liang concluded that the individual insurance market is not viable for those in need.

The story is "The Uninsurables," a CBS News Investigates Special Report. Professor Liang was interviewed by Armen Keteyian, Chief Investigative Correspondent.

Institute of Health Law Studies and Health Law Society Host 3rd Annual San Diego Health Policy Conference, "Safety Issues and Biologic Drugs"

May 4 , 2007. The Institute of Health Law Studies with assistance from the CWSL Health Law Society hosted the 3rd Annual San DIego Health Policy Conference, "Safety Issues and Biologic Drugs" in San Diego, CA. The conference brought experts from industry, academia, and government to discuss the emerging legal and policy issues influencing safety in the field of biologic drugs.

Participants included Institute Executive Director Professor Bryan A. Liang, MD, PhD, JD, James N. Class, PhD, PhRMA, Thomas T. Kubic, Pharmaceutical Security Institute, Lewis T. Kontnik, JD, Amgen, Inc., Kevin Lammons, JD, FBI, Rick Roberts, Patient Advocate, Adam Dorin, MD, MBA, Sharp Grossmont Plaza Surgery Center, Shirin Dorin, DDS, San Diego Dental Society, Shalizeh Nadjmi, Esq., US Department of Commerce, Gregory Schulte, City of San Diego, John Theriault, MBA, Pfizer, and Jozef Van Langendonck, PhD, Katholieke Universiteit Leuven.

Papers from the conference will be published in an upcoming issue of the Journal of Biolaw and Business. The conference was underwritten by a generous grant from the Castetter Family Foundation, and in cooperation with the Partnership for Safe Medicines and the San Diego Center for Patient Safety, University of California, San Diego School of Medicine.

Professor Bryan A. Liang Interviewed by CNN Money on US Supreme Court Patent Case

May 1 , 2007. The US Supreme Court decision holding in KSR v. Telex has made intellectual property protections much more difficult to obtain. Although an engineering case, it appears to have profound implications for patented medicines. CNN Money interviewed Professor Bryan Liang on its implications for the pharmaceutical industry.

Dr. Liang indicated that extended release and other changes to drugs that were formerly patentable will now face many more challenges. He also added that intellectual property litigation will likely expand. "Most certainly, there will be a push by generic companies to take advantage of this ruling and now we're in a new legal ballgame," he noted.

The story is "Supreme Court Ruling Could Squeeze Big Pharma," by Aaron Smith, CNN Money Reporter. It is available here.

Executive Director Bryan A. Liang Gives Ethics Presentation to Combined Otolaryngology Annual Meeting

April 27 , 2007. Executive Director Professor Bryan A. Liang gave the presentation, "Genetic Research and Conflict of Interest: Legal and Ethical Precepts" at the Otology Forum: Stem Cell and Genetic Therapies for Hair Cell Related Hearing Loss session of the Combined Otolaryngology Annual Meeting.

"The field of genetics will generate more than half of all the new therapies by the next decade," noted Dr. Liang. "But accompanying this development in science, conflict of interest issues will arise. The law, medical ethics, and professional review by state boards of practice have come into play in this area, and focusing on transparency of the benefits to the physician is critical to maintain trust now and in the future."

The event was chaired by Rick Friedman, MD, of the House Ear Clinic in Los Angeles, and also included Neil Segil, PhD, also of the House Ear Clinic, and Alan Ryan, MD, from UCSD School of Medicine.

Professor Bryan A. Liang Testifies Before California Assembly on Post-Claims Underwriting Bill

April 24 , 2007. Professor Bryan A. Liang testified before the California Assembly Standing Committee on Health in support of AB 1324. This bill would address the practice of post-claims underwriting, where a health insurer cancels an individual's health insurance after authorization in order to avoid paying for treatment. The bill would prevent insurers from skirting their obligation to pay for health care once authorized and rendered by the health care provider.

"Post-claims underwriting is illegal, but insurers in this state are engaging in the practice," said Professor Liang. "AB 1324 would address this heinous practice by providing no financial incentive to cancel policies after treatment authorization and provision. Most importantly, it would send a clear, strong consumer message to insurers: you authorize it, you pay for it, and nothing you do afterwards changes that," said Dr. Liang.

AB 1324 is sponsored by Assembly Member Hector De la Torre, whose office requested Professor Liang to testify.

Executive Director Professor Bryan A. Liang Gives Ethics Presentation at Whitehill Seminar Series

April 9 , 2007. Professor Bryan A. Liang gave the presentation, "Terri Schiavo: Ethics and Professional Commentary" at the Center for Molecular Genetics, University of California, San Diego School of Medicine. The presentation was part of the Muriel Whitehill Biomedical Ethics Seminar Services.

Dr. Liang analyzed the Terri Schiavo case from the perspective of assessing the ethical responsibilities of professional commentators in the case. He noted, "As we all saw, everyone had an opinion, and many were as uninformed and apart from fact as they could possibly be. Yet our professional organizations continue to allow this to happen." Professor Liang suggested that broader professional training and earlier exposure to media would be helpful in providing responsible commentary in controversial cases.

Dr. Liang was invited to give the presentation by Ted Friedman, MD, who is the Muriel Whitehill Chair of Biomedical Ethics at the University of California, San Diego School of Medicine. The series has included presentations from Mary Devereaux of the UCSD Research Ethics Program, Floyd Bloom, MD, President's Council of Bioethics, as well as other leaders in the biomedical ethics area.

Radio News Programs Interview Professor Bryan A. Liang on Follow-On Biologics Proposal

April 5-6, 2007. With recent House and Senate Committee hearings on a major proposal to allow on follow-on biologics, tremendous interest has been raised on this topic throughout the U.S. Follow-on biologics are copies of originator injectible drugs that are thousands to millions times larger than chemical medicines and are made using life forms such as bacteria, yeast, and mammalian cells rather than combining chemicals in a flask. During the recent Congressional recess, radio news programs interviewed Professor Bryan Liang on the bill.

Professor Liang noted that "the bill does not take into account the horrific lessons lessons learned in the EU, where even fully tested biologics resulted in unwanted immune reactions and patient deaths. Based on this experience, the EU created a safety-based system for follow-on products that requires drug clinical trials, allergic/immunologic testing, and risk management plans to ensure patient safety." Dr. Liang also noted that the discounts on these drugs will be limited. "The EU and Australia have only experienced 10-15% discounts on these copies, so 'access' may be more a political term here than one that means something to us outside the beltway."

Dr. Liang was interviewed by stations in CA (KFWB Los Angeles), CO (KXKL Denver), MA/NH (WTAG Boston-Manchester), NC (WFNC Raleigh-Durham), GA WAOK (Altanta), SC (South Carolina Network), TX (KRLD Dallas), WA (KOMO Seattle), as well as national syndicates USA Radio Network and MetroSource Network.

Professor Bryan A. Liang Interviewed for Story on Malpractice and Asset Protection

March 30, 2007. The challenges of legal actions against emergency department actions and individual providers have been increasing. ED Legal Letter interviewed Professor Bryan Liang regarding how physicians can protect themselves.

Dr. Liang noted that physicians should consider hiring their own attorneys rather than relying on malpractice insurance companies to protect their interests. Further, he indicated that physicians should focus on having a good relationship with patients as the best risk management tool. He stated that the optimal strategy for physicians is always to try avoid injury; using patient safety tools and to be honest and open with patients are the best way to avoid suits.

The story appears in the March 2007 issue of the ED Legal Letter.

Drs. Len Deftos and Bryan A. Liang Give Law and Medicine Presentations at Society of Surgical Oncology Annual Cancer Symposium

March 17, 2007. Institute Member Dr. Len Deftos and Executive Director Professor Bryan A. Liang gave two of the three presentations at the session, Medical Malpractice Issues for Surgeons at the 60th Annual Society of Surgical Oncology Cancer Symposium held in Washington, DC.

Dr. Deftos gave the presentation, "The Do's and Dont's of Being an Expert Witness," where he provided both a legal overview and the obligations of an expert witness in medical trials. Dr. Liang gave the presentation, "Patient Safety and Medical Errors: Tools to Avoid Patient Injury and Malpractice Lawsuits," in which he provided the theory of system safety, provided simple tools from the aviation industry to limit the effects of errors, and a strategy for disclosing medical errors.

Drs. Deftos and Liang were invited by Dr. Michael Bouvet for the session. Dr. Bouvet is a surgical oncologist at the UCSD School of Medicine.

Professor Bryan A. Liang Gives Plenary Presentation at Medicaid Rebate Conference

March 8 , 2007. Professor Bryan A. Liang gave the plenary presentation, "Crime and Counterfeits: Medication Madness and Policy Magic" at the 24th Medicaid Drug Rebate Conference. The event was entitled, "Successes and Continuing Challenges of Drug Rebate Programs."

"Counterfeit drugs are a drag upon the public and private sectors who are trying to provide medications to some of our most vulnerable citizens," noted Dr. Liang to a crowd of state Medicaid program and pharmaceutical company representatives. "However, these folks are smart. They know where the holes of the system are, and how to abuse them. We need to employ a multidisciplinary strategy of education, enforcement, technology, penal reform, and reporting to ensure that the next victim isn't one of our loved ones."

Dr. Liang is a well recognized expert on patient safety and the pharmaceutical drug supply. He is also on the Board of Directors of the Partnership for Safe Medicines.

Rady School of Business at University of California, San Diego Hosts Executive Director Bryan A. Liang "Follow-on Biologics" Presentation

March 5 , 2007. As part of its invited speaker seminar series, the Rady School of Business at the University of California, San Diego hosted Professor Bryan A. Liang for his presentation on follow-on biologics. His talk was entitled, "Regulating Follow-On Biologics: Just Good Enough for Government Work?"

Dr. Liang noted that "follow-ons are not "generics". Because biological drugs require life forms to be manufactured, they can never be copied identically like chemicval drugs, which are made from chemicals mixed together in a flask." He added that "current regulatory efforts ignore the scientific complexities of the medical and safety issues associated with biologics, and risk the health of some of our most vulnerable patients."

Dr. Liang was introduced by Jay Kranzler, MD, PhD, CEO of Cypress Pharmaceuticals and Adjunct Professor at the Rady School of Business.

Professor Bryan A. Liang Wins Outstanding Educator Award from University of California, San Diego School of Medicine

March 1 , 2007. Professor Bryan A. Liang was named by the students of the University of California, San Diego School of Medicine as the recipient of the Outstanding Educator Award. Students noted that Dr. Liang's "dedication to student learning establishes him as a model to be followed."

Individual student comments included that "Dr. Liang directly engages us in lecture and addressed issues important to us as future clinicians. He shed light on current health care issues that aren't merely political issues for policymakers, but real issues that will require support and involvement by doctors"; Dr. Liang is "an incredibly engaging speaker who not only brought the material to life, but connected us to the challenges we will be facing in our clinical practice"; and Dr. Liang is "a fantastic lecturer, clearly concerned with student understanding, and above all engaged students to think critically about the intersection of medicine and law."

Dr. Liang will be honored with a plaque engraved with his name at the University of California, San Diego School of Medicine.

Executive Director Bryan Liang Interviewed on Merck HPV Vaccine Controversy by KPBS

February 22, 2007. Recent efforts by Merck to push legislatures to mandate its new HPV virus vaccine, which prevents cervical cancer, has resulted in controversy stemming from objections by religious and parental groups. The KPBS program "These Days" interviewed Professor Bryan Liang on the topic.

Dr. Liang pointed out that the vaccine would protect women against cervical cancer after they are married and that parents could opt-out of such vaccination for their children. But, he noted, the aggressive lobbying activities of Merck has created a backlash that has put the public health benefits secondary to political concerns.

Professor Liang was interviewed by Tom Fudge, host of the "These Days" program. The interview can be found here.

Money Magazine Interviews Professor Bryan A. Liang on Post-Claims Underwriting

February 13, 2007. Heightented attention to the practice of post-claims underwriting by health insurance companies in individual policies has resulted in additional state investigations. Money Magazine asked noted expert and IHLS Executive Director Professor Bryan Liang for his comments.

Professor Liang noted that the tactics being used now by insurers are attempting to avoid risk, rather than manage it. He also warned that policyholders should be careful in cashing returned premium checks because they may be foregoing legal rights by doing so.

The story is "The Neutron Bomb of Health Insurance ," by Walter Updegrave and Kate Ashford, and is available here.

Bryan A. Liang Gives Presentation in Scripps Mercy Hospital Resident Lecture Series

February 13, 2007. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, gave a presentation to the medical residents at Scripps Mercy hospital on medical errors and patient safety. Dr. Liang is also Co-Director of the San Diego Center for Patient Safety at the University of California, San Diego School of Medicine.

He noted that "Medical errors are inevitiable. So the goal is to avoid preventable errors, but assume weaknesses in the system are going to result in errors, and take them into account when providing care so no adverse effects reach the patient. We can do this by using simple tools developed in other industries. But also, we should understand how to best disclose errors to injured patients to fulfill their needs and allow them to participate in the improvement of care."

Dr. Liang's presentation was entitled, "Medical Errors: Tools for Avoidance and Disclsoure."

Executive Director Professor Bryan A. Liang Lectures on Emergencies and the Public Health

February 8, 2007. With the importance of publich health preparedness and response, increasing attention has been paid to the scope of permiited activities by public health agents in these circumstances. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, as well as a member of the Center for Public Health Security at the College of Health and Human Services, San Diego State University, was asked to provide an overview to the preventive health program at the University of California, San Diego School of Medicine.

In the event of a major disaster or emergency, Dr. Liang noted that "public health authorities have significant power to mandate treatment, detain persons, take control over private propoerty, and generally act in the public interest." He also noted that "there are, however, limits to this authority, and there is a significant difference between having the authority, and actually being able to wield it. Cooperation between the public, public health, enforcement authorities, and first responders is always key to obtaining public health goals."

His presentation was entitled, "Public Health and Emergencies."

Professor Bryan A. Liang Comments on Privacy and Electronic Medical Records

January 31, 2007. Increasing pressure for and against use of electronic medical records has been debated recently on local and national levels. The Riverside Press-Enterprise interviewed Professor Bryan Liang if there were any patient privacy risks.

"It is unlikely that any filtering mechanism can be used currently that can prevent health care information to be abused," said Professor Liang. He noted there may be significant clinical impact. "This may create incentives for patients not to disclose everything to their provider, which would create problems for patient care."

The story is "Health care targets paper trail," by Lora Hines, and is available here.

Lethal Injection Article by Executive Director Professor Bryan A. Liang Makes "Top 25 List" for 2006

January 31, 2007. Professor Bryan A. Liang's article, "Lethal Injection: Policy Considerations for Medicine" made the Science Direct Journal of Clinical Anesthesia "Top 25 Articles" of 2006. In the article, Professor Liang reviews the history and current debate regarding lethal injection, and illustrates the concerns usings the Michael Morales case in California.

Professor Liang's article is the only non-clinical article to make the "Top 25."

Executive Director Bryan A. Liang Gives Conflict of Interest Presentation at Hemophilia Alliance Annual Meeting

January 31, 2007. IHLS Executive Director Professor Bryan A. Liang gave a presentation on conflict of interest to the Hemophilia Alliance Annual Meeting in San Diego. The presentation was entitled "Conflicts in Care: Legal, Personal, and Political Issues in Public Care Programs."

"Although 99.9% of the people providing services in public care programs are solely interested in the patient's welfare, sometimes we don't think about the subtle influences our funding and the patients we serve influence us," noted Professor Liang. "We have to be aware of the perception that we might have a conflict of interest when we order more drugs, or talk about our reliance upon the clinic for employment, or say negative things about another site of care."

Professor Liang was asked to speak by Derek Robertson, Executive Director of the Hemophilia Alliance. For more information on the Alliance, go to: http://www.hemoalliance.org.

Professor Bryan A. Liang Interviewed for NPR Marketplace Story on Novartis Lawsuit

January 29, 2007. Novartis, a Swiss-based drug company, is challenging patent laws of India, which it claims is in violation of the World Trade Organization “TRIPS”, or Trade-Related Aspects of Intellectual Property Rights Agreement. NPR Marketplace interviewed Professor Bryan Liang, an expert on pharmaceutical policy for his perspective on this issue.

Dr. Liang indicated that Indian patent laws may be in conflict with TRIPS, but both generic and brand name companies charge prices too high for access to drugs in third world countries. An appropriate approach would require both brand name and generic companies to participate in low cost/no cost drug programs to ensure access to medications for patients around the world.

The story is "Protests target drug company's patent fight," by Shia Levitt, NPR Marketplace. A transcript is available here.

Professor Bryan A. Liang Presents to the US Advisory Committee on Minority Health

January 22, 2007. With issues in health care becoming more and more dominant in the policy arena, concerns regarding disparities, limited English and health proficiency and their impact on quality of care and its costs are gaining headlines. Professor Bryan A. Liang, IHLS director, was asked to present some of his research in the area to the US Advisory Committee on Minority Health.

He stated that, "The statistics are soberting: almost half of Americans 65 and older have literacy challenges, and 1/4 to 1/2 of minority groups have little or no English spoken in their homes. Health care delivery errors and weaknesses disproportionately affect minority and vulnerable groups. We need to fashion public-private-community partnerships to address these issues now because these problems are not going to go away."

Dr. Liang was asked to present to the Committee by Dr. Garth Graham, Deputy Assistant Secretary for Minority Health at US Department of Health and Human Services. Dr. Liang is also a member of the Committee.

L.A. Times Quotes Professor Bryan A. Liang on Insurance Practices

December 31, 2006. In the continuing assessment of post-claims underwriting practices, additional insurers are being found to participate in the practice. The Los Angeles Times interviewed Professor Bryan A. Liang, who is a noted expert on the issue.

Professor Liang indicated that the insurers were seeking not to spread risk, but to avoid it altogether, which is a violation of public policy. He also noted that there will be hearings in January 2007 on the topic.

The article is "Health? Insurers Don't Buy It," by Lisa Girion. It is available here.

KPBS Radio “These Days” Interviews Dr. Bryan A. Liang on the California Death Penalty Ruling

December 20, 2006. After federal court Judge Jeremy Fogel issued an opinion holding that current State of California lethal injection protocols may be cruel and unusual punishment, the KPBS radio program “These Days” interviewed Professor Bryan Liang on the legal and medical implications of the judge’s ruling.

Professor Liang indicated that the state would have to address the areas of training, logistics, recordkeeping, and standardization in the lethal injection procedure at a minimum to bring it within acceptable Constitutional boundaries. He also noted that it was important that the court did not require medical personnel to act in the execution because it would violate medical ethics pronouncements.

The program is "California Death Penalty on Hold," on the KPBS Radio program "These Days." It is available here.

E! Entertainment Network "True Hollywood Stories" Program Interviews Professor Bryan A. Liang on Internet Pharmacies

December 2, 2006. With the advent of online marketing and access by vulnerable groups, such as children and the elderly, E! Entertainment Network interviewed Professor Bryan Liang about the dangers of the Internet with respect to rogue online pharmacies. Professor Liang described how these criminals supply drug of abuse and fakes without a prescription and the deaths that have occurred from these activities.

"Either the youth get active ingredient drugs of abuse, which kills them, or the seniors get fake life saving drugs, which kill them through these online pharmacies. No one needs a prescription," said Professor Liang. He added that "the proceeds fund criminal operations and more sales. This is a scourge upon patients and must be addressed to save us from a generation of addicts and to protect our vulnerable elderly population."

The program is E! Entertainment Network True Hollywood Stories and aired December 2, 3, and 4, 2006.

CNN Money Quotes Bryan A. Liang on Vioxx Lawsuits

November 22, 2006. A federal district court recently denied class action status in the Merck Vioxx trials. CNN Money interviewed Professor Bryan Liang about the implications of the ruling.

Professor Liang noted that this was an appropriate ruling because of the health differences between different plaintiffs suing Merck. However, he also noted that the ruling favored Merck because each case now has to be tried individually and will be more costly, deterring some plaintiffs.

The story is "No Class Action Status for Federal Vioxx Suits," by Aaron Smith, and is available here.

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Executive Director Professor Bryan A. Liang Appears on CNN Anderson Cooper 360 To Discuss "Post-Claims Underwriting"

November 21, 2006. Cancellation of individual health insurance policies after a health claim has been filed is under the scrutiny of the California regulators. CNN Anderson Cooper 360 interviewed Professor Bryan Liang about the practice and what is being done to address this problem.

Dr. Liang indicated that that this practice, known as “post-claims underwriting,” initiated by health insurers is illegal. He noted that the problem requires policymaker attention to protect vulnerable patients from losing coverage when they have high health care costs. "The potential costs are huge for those who lose their insurance, including the costs associated with care, as well as the inability to secure any health insurance in the future."

Los Angeles Times Interviews Professor Bryan A. Liang on Generic Biological Drugs

November 11, 2006. The push for cheaper medicines has raised Congressional attention to biotechnology drugs. The Los Angeles Times interviewed Professor Bryan Liang on the potential for Congress to pass generics-type legislation for biologic drugs.

Dr. Liang noted that although there are some types of biotech drugs that can be copied, most modern biologics are much more complex than chemical medicines, and are sometimes hundreds to thousands of times larger and requiring living cells for manufacture. He indicated that the FDA will likely move slowly in approving these “follow on biologics.”

The article is "Generic Biotech Drugs Backed," by Daniel Costello, and is available here.

American Medical News Story on Blue Cross Insurance Abuses Features Comments by Professor Bryan A. Liang

November 6, 2006. The Blue Cross actions rescinding individual health insurance policies has significant effects upon physician and hospital payments. The American Medical News interviewed Professor Bryan A. Liang on the current situation.

"The problem has been getting more obvious now that it has reached the middle class," said Professor Liang who is also a physician. "It's all about the money, and physicians who aren't paid by the insurance company are left holding the bag," he noted.

The story is "Individual health plans come under scrutiny in California," by Jonathan Bethely.

National Committee for the Prevention of Elder Abuse Names Executive Director Bryan A. Liang to Board of Directors

October 26, 2006. The National Committee for the Prevention of Elder Abuse named Institute Executive Director Bryan A. Liang to its Board of Directors. The announcement was made at the NCPEA's annual meeting.

"The NCPEA is a leading force in the protection of seniors in this country," said Professor Liang on the announcement. "I am gratified that the NCPEA has allowed me the privilege to serve. Hopefully we can create important changes from the grassroots to policy levels so that the scourge of elder abuse is effectively addressed."

The National Committee for the Prevention of Elder Abuse is an association of researchers, practitioners, educators, and advocates dedicated to protecting the safety, security, and dignity of America's most vulnerable citizens. For more information, got to: http://www.preventelderabuse.org/about/about.html.

Professor Bryan A. Liang Gives Lucien P. Jassey Distinguished Lecture at Scripps Mercy Hospital

October 24, 2006. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, gave the Lucien P. Jassey Distinguished Lecture at the Scripps Mercy Hospital. His presentation was entitled, "In Situ Simulation: Identifying Communications and Systems Issues in High Intensity Clinical Settings."

Dr. Liang began by noting that "High intensity clinical settings, such as ICUs, labor and delivery, and emergency departments, are unique: they are places where the pressures of intense care strain the system resulting in errors and system weaknesses that could reach the patient. The harm is also potentially severe. But on the other hand, HICS are really just like any other place in the facility, where communications and local systems issues result in optimal or less optimal care delivered to the patient."

He added that "traditional simulation is didactic, using an artificial laboratory and a philosophical mindset that is best depicted by Descartes. Yet if we want to address our local issues in our own settings, we need to know what happens in our facility with our people. That is where in situ simulation comes in; these simulations allows us to determine where our system weaknesses are by experiencing them ourselves in our facility. It allows us to observe our communications challenges with our own co-workers and own infrastructure. In that way, we can truly identify the path to safety through respect and empowerment of each member of the health care team."

Dr. Liang described the process of in situ simulation development and showed clips of the process to illustrate the concepts for the audience.

Dr. Liang was invited to give the Jassey distinguished lecture by Dr. David J. Shaw, Director of Graduate Medical Education at Scripps Mercy and Clinical Professor of Medicine at UCSD School of Medicine, and Dr. Stanley A. Amundson, Director of the Internal Medicine Residency Program, Scripps Mercy Hospital and Clinical Professor of Medicine at UCSD School of Medicine.

KCBS Radio Interviews Professor Bryan A. Liang on Impending Deadline for John Muir Hospital and Blue Cross Contract Negotiations

October 19, 2006. In light of the John Muir Hospital and Blue Cross deadlock in negotiation for reimbursement and coverage of thousands of patients in the San Francisco area, KCBS interviewed Professor Bryan A. Liang for his insights on the situation.

He noted that "there are significant patient safety issues associated with transferring care on short notice, and these safety concerns should be recognized. Unfortunately, these are contract negotiations where the patient gets left out in the cold." Dr. Liang added that "in addition, Blue Cross’ claim that it should be allowed to deny payment for care it has previously authorized at John Muir Hospital is contrary to California law. So the John Muir situation relates to the current Blue Cross lawsuits in southern California."

A summary of the interview is available at: http://www.kcbs.com/pages/111213.php?contentType=4&contentId=226626.

Executive Director Professor Bryan A. Liang Addresses the Pharmaceutical Security Institute General Assembly

October 18, 2006. The issue of counterfeit and diverted drugs around the world is a significant one. Raising awareness has also been a challenge for the industry and its security efforts. The Pharmaceutical Security Institute asked Professor Liang to provide insights on the physician awareness and perspective regarding counterfeits.

"Simply put, physicians do not have counterfeit pharmaceuticals on their radar screen," noted Dr. Liang. "Unfortunately, they believe this is a smokescreen of big pharma. Worse yet, they don't suspect counterfeits when there is therapeutic failure associated with patient care," he added.

Dr. Liang discussed how engaging patient groups and the problem of counterfeits as a policy issue using the paradigm of health literacy, which has become an important medical issue over the past five years. "Lessons can be learned from this experience, including narratives, stakeholder engagement, and easily implemented solutions, such as adding a simple question to the medical interview: where did you buy your medicines?"

The Pharmaceutical Security Institute is a not-for-profit, membership organization dedicated to protecting the public health, sharing information on the counterfeiting of pharmaceuticals, and initiating enforcement actions through the appropriate authorities. For more information, go to: http://www.psi-inc.org.

Executive Director Bryan A. Liang Interviewed by KPBS Radio on Blue Cross Settlements

October 18, 2006. The increasing intensity of investigations relating to Blue Cross health policy cancellations have created additional concerns for patients. KPBS Radio interviewed Executive Director Professor Bryan A. Liang on the implications of the Blue Cross activities.

"Blue Cross has settled many of these suits," noted Professor Liang. "Yet the Department of Managed Health Care continues to assess what is happening in these individual health policy cases. Patients need to be aware of the aggressive business practices that insurers underwriting individual policies are engaged in. Patients who have been harmed should contact the Department of Managed Health Care immediately to determine their recourse." Dr. Liang noted that Kaiser Permanente has been ordered by the Department to reinstate an individual health policy that was inappropriately canceled.

Professor Liang was interviewed by health reporter Kenny Goldberg for the KPBS story, "Blue Cross Agrees to Settle Lawsuits."

Dr. Bryan A. Liang Comments on Blue Cross Settlements of Health Insurance Lawsuits in Los Angeles Times Article

October 18, 2006. The furor and investigations over Blue Cross termination of individual health policies after a large claim is filed by policyholders has put tremendous pressure on the insurer. It was announced today that Blue Cross was settling 70 of these suits. The Los Angeles Times interviewed Professor Bryan A. Liang on this most recent development.

"Unfortunately, this is a standard way to avoid setting any precedent for future accountability," said Dr. Liang, Executive Director of the Institute of Health Law. Blue Cross "can easily pay off individuals, and those individuals have to take it to move on with their lives and recover from the horrors of having their health insurance taken away." Dr. Liang noted that without precedent, and settlements that require policyholders to withdraw their claims, it will be difficult for any action to be taken against the insurer for its abuses.

Dr. Liang is a noted commenter on this issue, including being interviewed in the initial series of stories that exposed the practice as well as on CNN and in other forums.

Blue Cross Settlement Raises Issues for Future Policyholders Says Professor Bryan Liang on KCBS Radio Money 101

October 18, 2006. Concerns about insurer cancellation of individual health policies has led to California regulators scrutiny of business practices. In light of this attention, Blue Cross has settled 70 of lawsuits claiming it illegally canceled individual health policies. KCBS interviewed Professor Bryan A. Liang for his perspective on the implications for future applicants and policyholders.

"If you are applying for a policy, you have to pay attention to these tactics," he indicated. Professor Liang added, "Specifically ask the insurers if they need any additional information or clarification at the time you apply, and note you know about the Blue Cross situation and want to avoid it. You need to protect yourself, and being a harder target to have your policy canceled will do just that."

The California Department of Managed Health Care has also fined Blue Cross $200,000 for its inappropriate cancellation of an individual health policy.

Professor Liang Gives Update on Law in Medicine at UCSD School of Medicine

October 17, 2006. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, and Associate Professor of Anesthesiology, UCSD School of Medicine, gave a law and medicine update lecture to the UCSD School of Medicine Class of 2009.

"Law impacts so many different areas of medicine, and it will influence how you interact with patients and how you advocate for them," noted Dr. Liang. "Not only does law touch on medicine in traditional areas such as medical malpractice and informed consent, but also areas such as conflict of interest, advance directives, and most recently the insurance litigation against Blue Cross and other insurers," he added. He advised that "you don't need to be a lawyer, but you need to have a feel for these areas and ensure your specialty societies keep you abreast of recent developments so you can do the best job for your patients."

Dr. Liang was asked to address the class by Dr. Rusty Kallenberg of the UCSD Department of Family and Preventive Medicine.

Buffalo Sunday News Published Op Ed by Professor Bryan A. Liang on Customs and Border Protection Bill

October 15, 2006. In the wake of Congressional passage of the Customs and Border Protection funding bill with a provision that does not allow CBP agents to seize pharmaceuticals purchased in Canada and brought back to the US, Professor Bryan A. Liang commented on the ethical and legal issues associated with this policy.

Dr. Liang noted that, "First, Canadian law prohibits pharmacists from dispensing drugs without receiving a valid prescription written by a licensed Canadian physician. Second, it is becoming increasingly popular for Canadian doctors to 'launder' American prescriptions by co-signing scripts that are written by U.S. doctors, and this is generally done without the Canadian doctor seeing the patient or having a substantive physician-patient relationship.

"Considering that these activities are a flagrant violation of professional ethics and Canadian law, the newly passed measure would put U.S. citizens in a precarious position - and it would place the safety of America's most vulnerable patients at risk."

Professor Liang also pointed out that any money spent by seniors for these drugs will not count toward their out of pocket costs in the Medicare Part D program.

The op ed is "New Canadian drug law is a prescription for danger," Buffalo Sunday News, and is available at: http://www.buffalonews.com/editorial/20061015/1018758.asp. The Buffalo News is the nation's 51st largest paper with a subscription base of 290,000+.

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Executive Director Bryan A. Liang Lectures on Patient Safety to UCSD School of Medicine

October 10, 2006. Patient safety is an important concern in the health care enterprise. Dr. Bryan A. Liang, Executive Director and Professor of Law, Institute of Health Law Studies, and Co-Director and Associate Professor of Anesthesiology, UCSD School of Medicine was asked to provide his expertise to the Class of 2009.

"Patient safety isn't a vague concept or overengineered set of jargonesque terms. It's a culture of accepting errors and system weakness and a transparent effort to identify and do something about them," he noted. "There are simple tools applicable from other industries such as aviation that allow us to increase safety and make our systems resilient to errors and system weaknesses," he added. Dr. Liang then went on to outline the "six pack plus one" set of practical tools that can be used to improve safety and "situational awareness" for the provider team.

Dr. Liang was asked to provide his insights by Dr. Rusty Kallenberg of the Department of Family and Preventive Medicine, UCSD School of Medicine.

IHLS Executive Director Professor Bryan A. Liang Gives Presentation on Counterfeit Drug Risks

September 29, 2006. Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, gave an invited presentation at the Quinnipiac University School of Law on issues associated with counterfeit drugs.

"Problems with counterfeits pervade different areas of our drug supply chain," noted Professor Liang. "Domestic concerns about how drugs are tracked and what can be done require true coordination between law enforcement here as well as internationally to address this threat."

Professor Liang was invited by Stephen Lathan, JD, PhD, Director of the Center for Health Policy at Quinnipiac.

Professor Liang Comments on Drug Importation Issues at Medicaid Conference

September 26, 2006. With increasing budgetary pressures on state Medicaid and other public payor programs, the costs of drugs has arisen as a key issue for policymakers. At the 11th Annual Summit on the Medicaid Drug Rebate Program & Other Public Sector Reimbursement Programs, Professor Bryan A. Liang was asked to give his views on the potential for drug importation and its associated risks.

"At the present time, enforcement of drug importation laws is up in the air," noted Dr. Liang. "With new Congressional proposals seeking to allow personal, but not online or mail order purchases over the Canadian border, there will need to be some legal clarification. Issues such as licensure, problems of Canadian pharmacists filling US prescriptions in direct contravention to their ethics and the law, may spur lawsuits and objections on both sides of the border."

Dr. Liang was joined by Institute Member James Class, PhD, who moderated the session, as well as Andy Troszak, of extendedcarepharmacy.com, a Canadian international mail order pharmacy. Mr. Troszak was a speaker at the 1st Annual San Diego Health Policy Conference, held by the Institute in 2005.

Professor Bryan A. Liang and Research Associate Laura Lin Give Community Law School Presentations on Elder Abuse

September 20, 2006. Institute of Health Law Studies Executive Director Bryan A. Liang and Institute Research Associate Laura Lin, RN, MBA, JD presented two public information seminars on financial elder abuse and signs and symptoms of elder abuse at Scripps Miramar Public Library. The forum was Community Law School, a public venue where members of the legal community provide important information to the public on key community issues involving legal rights and protections.

Professor Liang presented "Determining the Signs and Symptoms of Elder Abuse: Asking Questions, Making Observations, and Assessing Caregivers" in which he described methods to detect clues of potential elder abuse. Ms. Lin's presentation was entitled, "Older Adults and Financial Abuse," where she outlined the many different ways that seniors can be cheated and defrauded, new laws requiring reporting, and means by which to protect against such activities.

Professor Liang and Ms. Lin were invited by Ms. Palma Hooper, former President of the Filipino Lawyers Association and Pan Asian Lawyers Association, to present at Community Law School. The Community Law School is a joint service activity of the Southwest Center for Asian Pacific American Law, the Pan Asian Lawyers of San Diego, and the Filipino Lawyers of San Diego, and is supported by a grant from the San Diego County Bar Association.

Bryan A. Liang Addresses San Diego Disaster Council on Emergency Powers in Public Health

September 20, 2006. Dr. Bryan A. Liang, Executive Director of the Institute of Health Law Studies, addressed the San Diego Disaster Council on issues associated with emergency preparedness and the scope of powers in the event of a public health emergency.

"The most important aspects of emergency response beyond operationalization is the impact upon the 'grand slam' of rights: individual rights, professional rights, private property rights, and privacy rights," he said. "The impact can be best described by the 'Five Ds': in emergencies, one can Do medical things to people and Detain them for isolation and quarantine purposes; Direct professional actions; Determine what can be done with private property; and Disclose information about patients to relevant local, state, national, and international authorities."

The San Diego Disaster Council is an aggregation of first responders within the county representing public and private stakeholders engaged in planning for disaster preparedness. Dr. Liang was asked to present by Sherry Bookman, Co-Chair of the Council.

Los Angeles Times Interviews Bryan A. Liang on Blue Cross Announced Changes in Underwriting

September 20, 2006. In the wake of forthcoming sanctions against Blue Cross for its illegal underwriting policies against individual policyholders, Blue Cross announced changes in its review process for potential rescission of individual health insurance policies. These include an appeals process with a physician on the review committee, an ombudsman, and a simplified application form. Professor Bryan A. Liang, a noted expert on this topic, was interviewed for the story.

"I'm underwhelmed," said Professor Liang, Executive Director of the Institute of Health Law Studies. "The fundamental issue still is that they are not addressing these policies according to California law," he explained. "Once they issue the policy, unless there is actual fraud, they cannot rescind. So despite whatever window dressing they put in place, they are still violating the law."

The story is "Blue Cross Moves to Quell Furor: The health insurer, accused of dumping sick policyholders, says it will alter procedures," by Lisa Girion. It is available at: http://www.latimes.com/business/la-fi-revoke20sep20,1,5367030.story?coll=la-headlines-business.

CNN Interviews Professor Bryan A. Liang on Post-Claims Underwriting Cases Against Blue Cross and Blue Shield

September 17, 2006. The increasing national attention of the Blue Cross active rescission of individual policyholders health insurance when they file large claims has garnered national attention. CNN interviewed Professor Bryan A. Liang to get his legal and medical insights on the issue.

"The process is known as post-claims underwriting," Professor Liang explained. "In other words, rather than following the law to resolve any reasonable questions about a potential policyholder before the contract is written, as is mandated by law, the insurer waits until a large claim is filed and finds anything it can to claim that there was an omission or misrepresentation by the applicant so they can cancel the policy." He also noted from a medical perspective that "Insurers can use all sorts of vague, nonspecific signs and symptoms from a patient's past history to indicate they didn't disclose something that could be indicative of a present disease. Single laboratory values, nondescript physical findings, and other aspects of a medical history can be used by the insurer to 'justify' a rescission decision."

Dr. Liang also noted that the legal system also contributes to the limited attention to this issue. "Many of these patients are in small businesses or are vulnerable patients such as minorities and immigrants," he pointed out. "So first, these patients may not have the resources or knowledge to legally challenge these rescissions. Second, even if they do, their damages may not be enough for an attorney to take on their case. And even if they do get an attorney to represent them, they may settle for a very small amount of money, making it worthwhile for the insurer to constantly rescind these high cost contracts from a cost-benefit point of view, as well as not having any legal decisions on the books to be used against them."

The program will be aired as a special medical correspondence story by CNN.

Sunday Los Angeles Times Quotes Executive Director Professor Bryan A. Liang on Health Insurer Practices

September 17, 2006. With impending sanctions against Blue Cross for inappropriate practices withdrawing policies from individual health policyholders, more attention has been focused on how insurers issue these policies. The LA Times in an in depth feature story examined several cases and the law in the area. It interviewed Professor Bryan A. Liang for the story.

"The law is on the policyholders side," noted Professor Liang. The insurers quote a 1973 California Supreme court case; yet Professor Liang observed that even if what the insurers say is true, which he does not believe is correct, the California legislature 20 years later passed a law that specifically noted that rescissions of policies can only occur for policyholder "willful misrepresentation," in other words, active fraud.

The story is "Sick but Insured? Think Again" by Lisa Girion, available at: http://www.latimes.com/business/la-fi-revoke17sep17,0,6423805,full.story?coll=la-home-headlines.

Online Pharmacy Bill Op Ed by Professor Bryan A. Liang Published in The Hill

September 13, 2006. Unregulated online pharmacies represent major risk to patients. A bill has been introduced in Congress by Senators Diane Feinstein and Jeff Sessions to regulate online pharmacies by requiring prescriptions. Dr. Bryan Liang commented upon the bill and indicated that although a good start, online pharmacies must be regulated more stringently through certification or accreditation.

"Unregulated online pharmacies are a prescription for disaster," noted Dr. Liang. "Tragic stories of people who’ve died after purchasing controlled substances through online pharmacies have become all too common. For example, Ryan Haight, a straight-A, talented high school scholar and athlete died because of an overdose of Vicodin, a powerful painkiller that he’d purchased without a prescription through an unregulated Internet pharmacy.

"Further, selling drugs of abuse creates harm, unregulated online pharmacies also maim and injure patients by passing off fakes," he added. "Patients who access drugs through the Internet, who often represent some of the most vulnerable patient populations including the elderly and minorities, don’t know they are not getting the real thing because many diseases are 'silent.' ... Because of the lose-lose situation — patients getting the drugs of abuse they want; and patients not getting the drugs of treatment they need — online pharmacies must be effectively regulated. ... The Feinstein-Sessions bill could help solve this problem by mandating that online pharmacies be accredited or certified before they are allowed to sell."

The op ed is "Online Pharmacy Bill: A Good Start But Needs More," published in The Hill, September 14, 2006, available at: http://www.thehill.com/thehill/export/TheHill/Comment/OpEd/091406_pharm.html. The Hill is a non-partisan, non-ideological weekly newspaper covering Congress and its members. For more information, go to: http://www.thehill.com.

Executive Director Professor Bryan A. Liang Gives Plenary Lectures at Missouri Academy of Audiology Annual Conference

September 8, 2006. The Missouri Academy of Audiology convenes it annual meeting each year and brings experts from industry and academia from around the country for its Scope of Practice Convention. This year, it asked Professor Bryan A. Liang to present lectures on law, ethics, and audiology. Professor Liang provided two lectures, "The Law & Ethics in Audiology: Outlining the Borders," and "The Law & Ethics in Audiology: The Role of Professionalism."

"Audiology is subject to all the laws of conflict of interest, including the federal Antikickback Statute, the Stark Self-Referral Prohibitions, and the False Claims Act," noted Professor Liang. "With the federal government's increasing scrutiny of equipment manufacturers, audiologists must be cognizant of these laws and their state law equivalents."

Dr. Liang added in his professionalism lecture that "law, generally, is about the 'driving test model', or just being 'good enough,'" he said. "However, professional ethics and professionalism mandate that we strive for excellence and ensure that the patient is our primary focus. If we do so, we will always exceed what the law requires of us, and will rarely encounter circumstances where the law creates problems for appropriate clinical practice."

This is the second meeting of the Missouri Academy of Audiology at which Dr. Liang was invited to speak. For more information on the Academy, go to: http://www.maaaudiology.org.

Professor Bryan A. Liang Gives Guest Lecture on Healthcare Problem Solving

August 29, 2006 - Institute of Health Law Studies Executive Director Professor Bryan A. Liang gave the guest lecture, "Creative Problem Solving: Applying Lessons from Healthcare to Healthcare," in the class Problem Solving and Prevention in Health Care.

"The lessons we get from history of health care delivery reform—including the hard knocks—provide us with information on how to go from where we are to where we want to go. Litigation's assumptions, arbitration's disadvantages, mediation's incorrect use have provided us with lessons that allow for substantive reform. Also, using tools from other industries such as aviation has allowed us to focus our goal of improving quality and safety in health care."

Professor Liang was invited to give the guest lecture by Professor Linda Morton, who is also a member of the Institute.

Drug Store News Interviews Professor Bryan A. Liang on the Acquisition of MinuteClinics by CVS Pharmacies

August 26, 2006 - Drug Store News interviewed Professor Bryan Liang on the recent acquisition of MinuteClinics by CVS. He commented upon the legal conflict of interest and fraud and abuse issues that will be associated with service delivery in outpatient pharmacies.

"The clear temptation and market potential of having a provider in an in-pharmacy clinic to steer patients to the CVS pharmacy is obvious," noted Professor Liang. "But if there is any payment or remuneration involved for that referral, there are significant conflict of interest issues that implicate the federal, as well as state, fraud and abuse laws. The market has to mature for us to see the ramifications of this business strategy.

The story is "Legal Issues Press Budding Industry Concern," by Antoinette Alexander in the August issue of Drug Store News. For more information, go to: http://www.drugstorenews.com.

E! Entertainment Network TV Features Professor Bryan A. Liang for Program on Online Pharmacies

August 24, 2006 - Professor Bryan Liang was interviewed for a future documentary on online dangers, including Internet drug sellers. He discussed issues of counterfeit drugs, ease of access of drugs of abuse, and the scope of crime associated with “Internet drug pushers.”

"The risks of online pharmacies are tremendous, but particularly to the young and old," said Professor Liang. "Drugs of abuse, such as morphine derivatives, sedatives, steroids, and others are being sought after by youth. Unfortunately, some of these drugs are tainted or made under unsanitary conditions, and are creating a generation of addicts. On the other hand, seniors and others attempting to obtain life saving and quality improving drugs at cheaper prices are getting counterfeits that either don't treat their disease or actually harm them because of the materials that are being used," noted Dr. Liang. "This creates a completely lose-lose situation for everyone—except the pushers."

The E! documentary program will air in November.

KPBS Program "These Days" Interviews Executive Director Bryan A. Liang on the Vioxx Litigation

August 22, 2006 - With the New Orleans verdict of $51 million against Merck and a New Jersey state court overturning a pro-Merck verdict, the Vioxx litigation is very much in the news. The KPBS radio program "These Days" interviewed Institute Executive Director Professor Bryan A. Liang on the implications of these developments.

"The one-two punch suffered by Merck is of great significance for future Vioxx litigation," said Professor Liang. "The original momentum that seemed to favor Merck has ground to a halt. Merck, and its attorneys, will have to review their strategy of picking apart a plaintiff's medical history, and quickly get some scientific support for their position that Vioxx was not the cause of patient stroke and heart attacks."

Referring to the Merck Vioxx study that the New England Journal of Medicine retracted because Merck researchers did not disclose all adverse patient data, Dr. Liang noted that "this will play badly with the jury. It clearly looks like Merck lied, and creates the strong impression that Merck has little integrity both in the professional as well as patient worlds."

The interview is "Merck loses another Vioxx case," with Maureen Cavanaugh. It is available here.

Professor Bryan A. Liang Presents at Global and Border Emergency Preparedness Conference

August 18, 2006 - With the increase in natural and man-made threats, governments, providers, and others require information on emergency preparedness. The San Diego State University Global and Emergency Preparedness Program held the 1st Annual Public Health Institute on this topic. Professor Liang gave the presentation, "Public Health Emergency Powers: The Scope of Permitted Action" to an audience of physicians, nurses, paramedics, public health professionals, law enforcement, military, and first responders.

"Public health powers in emergencies are broad," said Professor Liang, who is Executive Director of the Institute of Health Law Studies, as well as Co-Director of the San Diego Center for Patient Safety at UCSD School of Medicine. "You've got the power of the '5Ds': do and detain individuals, direct professional activities, determine the use of private property, and disclose otherwise confidential medical and personal information. As long as the intervention is reasonable, and there is a reasonable relation between the intervention and the public health goal, the public health activity is allowed."

The Public Health Institute was sponsored in part by the Early Warning Infectious Disease Surveillance, California Binational Boarder Health Initiative.

CNN Money Interviews Professor Bryan A. Liang About New Orleans Vioxx Verdict

August 17, 2006 - A federal trial court in New Orleans, Louisiana has found Merck liable for the injuries of Jerry Barnett, a 62 year old former FBI agent who took Vioxx. On the same day, a New Jersey state court judge threw out a former verdict favoring Merck on the basis of undisclosed scientific data. CNN Money asked expert Professor Bryan A. Liang for his reactions to these development.

Dr. Liang, Executive Director of the Institute of Health Law Studies, indicated that Merck lawyers typically have been successful by highlighting the health flaws of plaintiffs and the non-Vioxx conditions that may have led to their heart attacks.

But this strategy didn't work in New Orleans. He said the plaintiff lawyers effectively demonstrated to the jurors that Barnett was a robust former FBI agent who would not have suffered a heart attack, were it not for Vioxx. "From the point of view of Merck, this is a tremendous setback," said Dr. Liang. "What they thought was a great strategy, doesn't seem to be a great strategy anymore. The lawyers are really going to have to get together and figure out how they're going to deal with damage control."

From a business perspective, Dr. Liang said that Merck lawyers should try to find flaws in data being used against the company and to fight science with science by presenting these flaws to the jury. "It looks like Merck lied, and that doesn't look good to the juries, but if they can come up with an independent assessment that indicates that the additional data isn't going to change the conclusion about 18 months, then that's going to matter to the jury," he observed. "They've got to find a way to spin control this, and the way to do it is to spin the science."

The full story is "Merck's bad day in court: Federal jury finds drugmaker misrepresented painkiller, while New Jersey judge tosses out earlier verdict that favored it," by CNN Money reporter Aaron Smith. The story is available here.

Investor's Business Daily Interviews Professor Bryan A. Liang on Federal Probe into Authorized Generics

August 11, 2006 - The use of authorized generics is the practice by brand name firms of introducing their drugs as "generics" during a marketing period usually reserved for independent generic companies that have successfully challenged an invalid brand name patent. Brand name firms claim the practice lowers prices for consumers; generic firms claim it is anticompetitive. In light of a Federal Trade Commission announcement that it will be looking into the practice, Investor's Business Daily interviewed Bryan A. Liang, Executive Director of the Institute of Health Law Studies for his perspective.

"Consumers are not saving money on the retail level in markets with authorized generics, and, further, they are facing higher branded prices," said Dr. Liang. Dr. Liang is a co-author of a study that assessed the issue and is a former FTC analyst who investigated the issue. He also noted that independent generic drug makers might not bother to enter the market if marketing exclusivity is not assured. "The incentives for these generic companies to weather patent challenges and create noninfringing processes to get generic drugs to the market faster is dramatically undermined," he said.

The piece is "Feds Look Into Battle Over Authorized Generics," Investor's Business Daily, August 11, 2006, by Peter Benesh. The full article is available here.

CNN Money Interviews Executive Director Bryan A. Liang on California Vioxx Verdict

August 1, 2006 - A California jury recently held that Merck was not liable to a 71 year old plaintiff who claimed the drug Vioxx caused his heart attack. This is the first case with a jury verdict in California. CNN Money interviewed Dr. Bryan Liang and asked him to comment on the verdict.

"I think [Merck is] doing the right thing, at least from a cost-benefit point of view," said Bryan Liang, Professor of Law and Executive Director of the Institute of Health Law Studies at California Western School of Law when asked if Merck should continue its case-by-case litigation strategy. "Eventually they're going to wear people down. If they continue to get more wins, I think that some plaintiffs are going to say 'this is too much' and they're going to start dropping these cases."

Merck faces at least 2,500 cases in California. The story is "Merck vows to keep fighting the Vioxx war," by Aaron Smith, August 3, 2006, available here.

United Press International Quotes Professor Liang on Authorized Generics

August 1, 2006 - UPI Health Business Correspondent Olga Pierce assessed the use of authorized generics by brand name pharmaceutical companies. Authorized generics are brand name drugs introduced as generics through a licensing process during a period of generic exclusivity granted to independent generic firms when they successfully challenge invalid brand name patents. Proponents say the practice saves consumers money; opponents of the practice argue that it is anticompetitive. Dr. Liang and co-author Professor Aidan Hollis answered reporter questions at a press conference releasing a study they performed on the practice.

"In our study, consumers saved nothing when an authorized generic was present," said Dr. Liang. "Further, not only were there no significant discounts in markets with authorized generics, the brand name form of the drug was actually priced higher in these markets," he noted. Professor Hollis added that "The most significant harm caused is a decreased incentive for generic firms to challenge patents."

The UPI analysis is "Authorized Generic Bad Medicine?" by Olga Pierce, available here.

Bryan A. Liang Featured on UCSD Panel Discussing Alternatives to the Physician-Scientist Pathway

July 31, 2006 - The University of California, San Diego School of Medicine Physician-Scientist Colloquium convened a panel to provide MD, PhD students with experiences of medical scientists who have taken alternative paths with their medical degrees. Dr. Bryan A. Liang, Executive Director and Professor of Law at the Institute of Health Law Studies, California Western School of Law, was an invited participant.

"Really, working in alternative areas really isn't straddling two or even three careers," said Dr. Liang, who is also Co-Director of the UCSD San Diego Center for Patient Safety. "It's finding your passion and following the threads of fabric you are weaving in your research that is part of the broader tapestry of society. You just have to make sure take the opportunities as they come, and go forth to try and influence how your work impacts the world around you both inside and outside of the laboratory."

Dr. Liang was joined on the panel by Christine Moutier, MD, Assistant Clinical Professor of Psychiatry and Assistant Dean for Students and Curricular Affairs, UCSD School of Medicine, who was formerly a concert pianist; and Robert Hertzka, MD, former President of the California Medical Association.

Executive Director Professor Bryan A. Liang Co-Authors Major Study on "Authorized Generics"

July 31, 2006 - Institute Executive Director Professor Bryan A. Liang co-authored the study, "An Assessment of the Effect of Authorized Generics on Consumer Prices," which was released today. This study raised policy questions as to the competitive effects of the practice of brand name drug companies introducing generics during a statutory period that is reserved for independent generic firms.

At the press conference announcing the study, Dr. Liang noted that, "We first reviewed a report by IMS Consulting, which found authorized generic market prices were significantly lower. We determined that this study had significant flaws, including use of wholesale data, no disclosure of pricing analysis, drawing conclusions from only two data points, and incorrect market entry dates."

He added, "we found using retail information that markets with authorized generics do not have lower prices than markets without them, and, in fact, brand name drug prices in these authorized generics markets were higher. So consumers are not saving money on the retail level in markets with authorized generics, and they are facing higher brand prices."

Dr. Liang concluded that "in the face of authorized generics obtaining market share during the statutory period supposedly reserved for independent generics, the incentives for these generic companies to weather patent challenges and create non-infringing processes to get generic drugs to the market and consumers faster are dramatically undermined. This may result in fewer cheaper generic drugs accessible to consumers in the near and long term."

For more information, click here. Dr. Liang co-authored the report with Professor Aidan Hollis, an economist at the University of Calgary. The report is available here.

Professor Bryan A. Liang Comments On Congressional Proposals to Limit Customs and Border Agent Seizures of Imported Drugs

July 27, 2006 - Executive Director of the Institute of Health Law Studies and Professor of Law Professor Bryan A. Liang commented upon the recent Congressional proposals to limit seizure of imported drugs by Customs and Border agents. He observed that Congress is confusing the separate issues of drug safety and health care access, and that the legal effect of these efforts is limited.

"Under the congressional proposals, Customs and Border agents on the front lines of ports, country borders and mail facilities, would be prohibited from seizing individual imports of medicines. Yet for decades these agents have been at the forefront of patient safety," Dr. Liang notes. "Further, the legal effect of these proposals is questionable. They indicate that medicines complying with the Food, Drug and Cosmetic Act cannot be seized by Customs and Border protection officials. Yet drugs for Canadian or another country's use brought from those locations into the United States are in violation of the act: They are labeled incorrectly for this country, are dispensed without a valid U.S. prescription, and/or are unapproved for use here." Dr. Liang concludes that "Instead of trying to export the problem of providing affordable health care in this country to Canada and elsewhere, Congress should directly confront the root cause of the issue: the price of drugs here."

Dr. Liang is also the Co-Director of the San Diego Center for Patient Safety, UCSD School of Medicine. The editorial is "A Concern About Drug Safety," published in San Diego Union Tribune, July 27, 2006. It is available here.

IHLS Executive Director Professor Bryan A. Liang Appointed to Alliance Healthcare Foundation Board of Directors

July 24, 2006 - IHLS Executive Director Professor Bryan A. Liang has been appointed to the Alliance Healthcare Foundation Board of Directors. The Foundation is one of the largest community healthcare service foundations in San Diego, with almost $75 million in assets.

"It is a great privilege to be asked to serve on the Alliance Healthcare Foundation Board of Directors," said Dr. Liang on the announcement. "Alliance has a tremendously important role in the San Diego community, and has been on the forefront of inovative program development and funding. I very much look forward to working with the Board and the Foundation to continue its activities."

The mission of the Alliance Healthcare Foundation is to promote health and wellness in the San Diego region, with special emphasis on the medically underserved. It accomplishes this goal through collaborative grantmaking, advocacy and education. In fiscal year 2006, the Foundation provided grants of almost $2 million to community programs in and around San Diego. For more information, click here.

BusinessWeek Online Quotes IHLS Executive Director Bryan A. Liang on Product Piracy Issues

June 26, 2006 - China is well known for being a source, and being awash itself in counterfeit products, including pharmaceuticals. A BusinessWeek Online story on the topic quoted IHLS Executive Director and Professor of Law Bryan A. Liang on the limits of technology such as radio-frequency identification (RFID) tags for authenticating pharmaceuticals.

"RFID tracks cardboard," noted Dr. Liang, who is also Vice President of the Partnership for Safe Medicines, a group of organizations and individuals that have policies, procedures, or programs to protect consumers from counterfeit or contraband medicines. "But drugs may be legally repackaged in places like the U.S. and Europe, giving criminals opportunities to hijack legitimate packaging for counterfeit medicines."

The story is "China tries to fight back against piracy," by Elaine Kurtenbach, Associated Press, BusinessWeek Online, June 29, 2006, available here. The article has been syndicated and has appeared in several dozen news outlets around the world. For more information on the Partnership for Safe Medicines, click here.

Professor Bryan A. Liang Presents Ethics and Recent Legal Developments Lecture at San Diego State University Audiology Program

June 26, 2006 - Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, gave the presentation, "The End of Innocence: An Update on Audiology, Law, and Ethics Post-Lincare and Missouri Board of Hearing." The presentation covered new developments in law and ethics relating to conflict of interest issues in the practice of audiology.

"Lincare dealt with the same kinds of inducements of free trips, cash, equipment, and other 'benefits' that really represent bribes to use their products and refer them to patients. The Missouri Board of Hearing case has broken the monopoly in some states that allowed only audiologists to sell hearing aids—leading to higher prices," explained Dr. Liang. "Now, the federal government is scrutinizing inducements for durable medical equipment, and the courts have spoken, indicating that patients can unilaterally purchase aids without an audiologist. In combination, these recent developments require audiology to focus on professional services, rather than product sales and their inducements to develop its role in the health delivery system."

Dr. Liang was invited to give his address by Dr. Jacque Georgeson, San Diego State University. Dr. Liang's comments will be published in a forthcoming issue of Audiology Today.

Executive Director Professor Bryan A. Liang Attends the US Department of Health and Human Services Advisory Committee on Minority Health Meeting

June 13, 2006 - Dr. Bryan A. Liang, Executive Director of IHLS at California Western School of Law, and Co-Director for the San Diego Center for Patient Safety at UCSD School of Medicine, attended the US Department of Health and Human Services Advisory Committee on Minority Health meeting held in Washington, DC. Dr. Liang is one of only 12 citizens in the US to serve on the committee.

"The meeting of the leaders in the area of minority health across the nation as well as by staff and the Assistant Secretary of Health and Human Services for Minority Affairs indicates the importance of this body as a policymaking entity," noted Dr. Liang. "Although we have much to do, our activities are clearly moving toward addressing key issues of limited English proficiency, cultural competency, and other critical health care concerns that impact the racial and ethnic minorities in this country."

Dr. Liang was invited to serve on the Committee by Secretary of Health and Human Services, Michael O. Leavitt. Dr. Liang was appointed to a four year term on the Committee. For more information, click here.

Professor Bryan A. Liang Addresses American Medical Association 2006 Annual Meeting of the House of Delegates on Patient Safety

June 12, 2006 - Dr. Bryan A. Liang, Executive Director and Professor of Law, California Western School of Law, and Co-Director and Associate Professor of Anesthesiology, UCSD School of Medicine, addressed the 2006 AMA Annual Meeting of the House of Delegates in Chicago, IL. His topic was "Patient Safety and the Quality Improvement Act of 2005: Communication, Culture, and Unanswered Questions."

"A primary barrier to progress in patient safety is the inability to discuss errors and system weaknesses openly and honestly with an eye toward improvement. Unfortunately, these efforts are often used against the reporter, and hence under these conditions, no one will talk. Aviation learned the lesson long ago that to improve safety within complex systems, full and open communication without fear of retribution is essential. The Patient Safety and Quality Improvement Act has the potential to allow such discussions to be had so that lessons learned can be widely disseminated, rather than discovered, if ever, by each institution through its own negative experience."

Dr. Liang was a prime force in supporting and crafting the bill's provisions. The bill was signed by the President July 29, 2005.

FDA Week Interviews Dr. Bryan A. Liang About RFID and Drug Security

June 9, 2006 - FDA Week, in investigating the security of the medicine drug supply, interviewed IHLS Executive Director Professor Bryan A. Liang. The FDA has indicated that it is focusing upon RFID (radio-frequency identification tags) to ensure the safety of the medicine supply chain in this country.

"RFID won't stop counterfeiters," said Dr. Liang. "RFID just tracks cardboard. As soon as you pull stuff out of the cardboard you have just lost all the protection." He added that repackagers take medications out of their original packaging and discard it, allowing counterfeiters to "harvest" this cardboard for their counterfeits, setting up a scenario where the counterfeits breeze through inspection while legitimate drugs would likely be stopped.

The story is "Drug Supply Security Expert Points to Weakness in RFID," published in FDA Week, June 9, 2006. For more information, click here.

Institute of Health Law Studies Hosts 2nd Annual San Diego Health Policy Conference "Terrorism, International Crime, and Medicine Security: Issues in a Global Marketplace"

June 9, 2006 - The Institute of Health Law Studies hosted the 2nd Annual San Diego Health Policy Conference, "Terrorism, International Crime, and Medicine Security: Issues in a Global Marketplace," held at the Hilton Harbor Hotel. IHLS Executive Director Bryan A. Liang gave the opening presentation, "Crime, Terrorism, and Counterfeit Drugs: Addressing the International Regime."

The conference comprised of presentations by a distinguished group of government, industry, and ground-based experts. In addition to Dr. Liang, conference presenters included John Lewis, FBI Inspector/Deputy Assistant Director Counterterrorism Division, Greg Schulte, Commercial Fraud Group, US Homeland Security/Immigration and Customs Enforcement, Tom Kubic, Executive Director Pharmaceutical Security Institute, R. John Theriault, Pfizer Vice President of Global Security, James N. Class, Executive Director Partnership for Safe Medicines, Katherine Eban, Investigative Reporter and author of "Dangerous Doses", Alan Cates, Director Fraud Prevention Institute, and Jim Thomson, CEO UK Centre for Mental Health.

Proceedings of the conference will be published in a forthcoming issue of the Journal of Biolaw & Business.

Executive Director Bryan A. Liang Appointed to US Department of Health and Human Services Advisory Committee on Minority Health by Secretary Michael O. Leavitt

May 25, 2006 - Institute of Health Law Studies Executive Director Bryan A. Liang was appointed to the US Department of Health and Human Services Advisory Committee on Minority Health. Secretary of Health and Human Services Michael O. Leavitt indicated that he hoped that Professor Liang would "give us the benefit of your valued expertise and counsel."

"It is a tremendous honor and privilege to be chosen to serve on the Advisory Committee on Minority Health," said Dr. Liang on the announcement. "There is so much that needs to be done to address the health and social welfare needs of minorities in this country. I am looking forward to the opportunity to work with the Committee to improve the public health of some of our most vulnerable citizens."

The Advisory Committee on Minority Health is comprised of 12 leaders from around the US. It advises the Department of Health and Human Services on improving the health of each racial and ethnic minority group in the country.

Supreme Court Denial of Death Penalty Case Review Unsurprising, Says IHLS Executive Director Bryan A. Liang in Associated Press Story

May 22, 2006 - The U.S. Supreme court today denied review of a lethal injection case that claimed the method was cruel and unusual punishment. This was the second recent lethal injection case the high court refused to consider on appeal. After the Court's decision, the Associated Press interviewed many experts in this area, including Institute of Health Law Studies Executive Director Bryan A. Liang.

"I don't believe that this was or is 'the' case for the Court to consider lethal injection and its use in implementing the death penalty," said Dr. Liang. "I really didn't think this particular case was going to bring down the entire death penalty jurisprudence of the last 25 years," he added. Professor Liang noted that it will probably be more narrowly construed civil rights laws that may be the manner by which the Supreme Court assesses the ability of prisoners to challenge the process of lethal injection.

The story is "Justices Deny Lethal Injection Challenge," by Toni Locy, AP Reporter. The Associated Press is a news organization with more than 240 bureaus worldwide that encompasses 1700 newspapers and provides continuous news coverage. For more information, click here.

Impact of New Vioxx Studies Depends on Spin, Says Dr. Bryan A. Liang in CNN Money Interview

May 19, 2006 - New studies have shown additional information on the risks of Vioxx for cardiac events in patients who stop taking the drug. But interpretation of the results depends on who one asks. CNN Money spoke to IHLS Executive Director Professor Bryan A. Liang about the implications of these new studies.

"If the information is malleable enough to be used by either side, the presentation might carry more weight than the actual data. It's not what they say, but how they say it," said Dr. Liang. "The Merck lawyers will say there is no statistical difference between patients who took the drug then stopped, but plaintiff attorneys may say, in terms of absolute difference numbers, that there is a difference," said Liang, referring to the post-Vioxx off-drug study.

While Dr. Liang warned against lawyers sliding into a war of numbers, he said that a winner could emerge from that strategy."If the trials and lawyer presentations go too much into statistics, the jurors aren't going to understand it and they're going to fall asleep because it gets boring," said Dr. Liang. "It's really going to be incumbent upon the lawyers to make it understandable, and the ones that make it the most understandable from their point of view are the ones who are going to win."

The story is "Vioxx: Best spinner could be the winner; Merck and plaintiffs could descend into war of stats in next trial over painkiller," by Aaron Smith, CNN Money reporter. The story is available here.

Asian & Pacific Islander American Scholarship Fund Recognizes IHLS Executive Director Dr. Bryan A. Liang for Service

May 17, 2006 - The Asian & Pacific Islander American Scholarship Fund recognized Professor Bryan A. Liang, Institute of Health Law Studies Executive Director and Professor of Law, for "exceptional service" to the APIASF. Dr. Liang acted as a scholarship reviewer for the Fund and reviewed several dozen applications for the APIASF.

"The potential of young people today is extraordinary, and the quality of students applying for the APIASF program scholarships reflect that potential," said Dr. Liang on the announcement. "The adversity that these young people have already overcome shows the resilience of the human spirit. I am honored by the recognition that APIASF has bestowed upon me, but of course the true honor is the acquaintance we all make with these high quality candidates."

The Asian & Pacific Islander American Scholarship Fund is a national organization devoted solely to the financial scholarship needs of Asian and Pacific Islander American students. The scholarship fund's historic formation is credited to founding corporations, community-based organizations and civic leaders. For more information, click here.

Associated Press Interviews Executive Director Bryan A. Liang About Drug Marketing Efforts

May 10, 2006 - With the recommendation by an FDA panel to allow the reintroduction of Tysabri, the Biogen Idec multiple sclerosis drug that was pulled off the market last year, the company has begun to court physicians to recommend the drug through "educational" programs. However, such activities are suspicious, noted Bryan A. Liang, Executive Director and Professor of Law, in an interview with the Associated Press.

"What you're seeing ... is marketing, rather than education," said Dr. Liang, Professor of Law and Executive Director of the Institute of Health Law Studies at California Western School of Law in San Diego. He added, "This is an example of the problems associated with folks ... who have a vested interest," he said, "so they can not only make money, but make up for the time they had to pull [the drug] off the market." He noted that what results is a system that allows drug companies to claim they are supporting educational activities when really the goal is marketing even before the FDA has approved the drug for re-introduction into the market.

The story is "Companies Educate People About Tysabri," Associated Press, May 10, 2006, by Brandie M. Jefferson. The Associated Press is a news organization with more than 240 bureaus worldwide that encompasses 1700 newspapers and provides continuous news coverage. News outlets that published the article include Business Week, the Houston Chronicle, the LA Times, the Fort Worth Star-Telegram, CBS News, and Forbes. For more information, click here.

Professor Bryan A. Liang Gives Legal Issues in Medical Practice Lectures at UCSD School of Medicine

May 4, 2006 - Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, gave members of the Class of 2008 of the UCSD School of Medicine insights as to the legal system and how it will affect their training and their practice career. As a lawyer and a physician, Dr. Liang provided the students with information and a unique perspective regarding the context of medicine in a rapidly changing regulatory climate.

"Law impacts every aspect of medical practice, from contracts to employer-employee relations to getting paid to issues of medical malpractice," said Professor Liang. "No one expects you to be an attorney—but understanding the legal system provides you with the tools to advocate for yourself and your patients while you practice in a world of third party insurers, increasing regulation, and decreasing resources."

Dr. Liang is also on the faculty at UCSD School of Medicine in the Department of Anesthesiology as well as is Co-Director of the San Diego Center for Patient Safety. He is a frequent guest speaker on legal topics at the School of Medicine.

New Vioxx Study Implications on Current Lawsuits Commented on by IHLS Executive Director Bryan A. Liang in CNN Money Story

May 3, 2006 - A new Vioxx study from Canada indicates that the risks associated with the drug for cardiac disease and stroke may occur only weeks after beginning its use. This finding is contrary to its manufacturer Merck's claims that elevated risk occurs only after its long term use. CNN Money interviewed IHLS Executive Director Professor Bryan A. Liang on the implications of this new study.

"Clearly, this creates issues for Merck, particularly after the recent decision by a Texas jury for a patient who had only used Vioxx a short period of time," said Professor Liang, who is also a physician. "Although the retrospective data from the Canadian study is not as strong as clinical studies, it comes from a reputable organization and will add ammunition to the fodder for plaintiff attorneys." He added that "It's going to really raise issues in juries' minds, for good reasons."

The story is "Canadian Vioxx study challenges Merck," by Aaron Smith, CNN Money Reporter. It is available here.

Blue Cross Insurer Practices Questionable Notes Professor Bryan A. Liang in LA Times Article

April 26, 2006 - The practice of Blue Cross health insurer, the largest in California, to retroactively cancel issued policies of ill members only after finding inconsistencies in their applications, rather than fraud, is legally questionable, commented Bryan A. Liang, Executive Director of the Institute of Health Law Studies. This comes perilously close to post-claims underwriting, an illegal practice under state law.

Professor Liang indicated that the practices outlined in a lawsuit against Blue Cross were troubling. "It just strikes me as so unfair and inequitable," said Dr. Liang, who is both a physician and lawyer. "If I were the attorney general, I'd want to look closely into this to find out what they are doing," he said. Once a policy is issued, Dr. Liang said, insurers by law "have to show actually willful acts of omission on the part of the applicant" to cancel coverage.

The state departments of insurance and managed health care have opened investigations into Blue Cross' activities. The full story is "Scrutiny of Sick Patients is Detailed," by Lisa Girion, LA Times Reporter. It is available here.

San Diego Business Journal Article on Fake Drugs Features Comments by IHLS Executive Director Bryan A. Liang

April 24, 2006 - The San Diego Business Journal front page article on fake drugs featured comments by IHLS Executive Director Bryan A. Liang. It also featured comments by speakers who will be participating in the forthcoming IHLS conference, "Terrorism, International Crime and Drug Security: Issues in a Global Marketplace," to be held June 9, 2006, in San Diego.

"The proximity to the border creates significant issues of flow of fake drugs from Mexico to San Diego," said Dr. Liang. Greg Schulte, Supervisor of the Commercial Fraud Group of the U.S. Immigration and Customs Enforcement and featured speaker at the upcoming IHLS conference, agreed. He noted his department is hearing that small pharmacies are feeling more pressure from large wholesalers such as Wal-Mart and Walgreens, and owners may be tempted to get cheaper drugs from Mexico, where drugs are not as strictly regulated — if at all.

“Many of those drugs are manufactured in places as far away as India,” he said. “Some of the manufacturing facilities look like meth labs.” This situation creates significant risks to patients in the U.S.

The full story is "Fake Drugs a Big Concern at U.S. Border," by Katie Weeks, and is available here (registration required). Dr. Liang, Mr. Schulte, and representatives from Pfizer, the Partnership for Safe Medicines, the UK Centre for Mental Health, the Pharmaceutical Security Institute, and other national and international commentators will be discussing these issues at the forthcoming IHLS conference. For more information on the conference, click here.

Professor Bryan A. Liang Interviewed and Quoted in Canadian Drugs News Article

April 22, 2006 - Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, was interviewed and quoted in a story on US pharmacies selling Canadian drugs. These US pharmacies are having Canadian doctors sign off on drugs in Canada so that they can be sold to US consumers and shipped south of the Canadian border.

Professor Liang, who is also a physician, noted that drugs imported from foreign sources that are for sale to US customers are not inspected to make sure the drug is as ordered, and that it is cared for or handled properly. "The drugs shipped to people in the US are not subject to Health Canada's regulation," said Dr. Liang, referring to Canada's health agency. "That means if the drugs are bad, there's no enforcement authority the consumer can appeal to." He added that Canadian doctors who rewrite prescriptions for patients they've never seen are acting contrary to medical ethics.

Professor Liang advises patients to buy from a local pharmacist so they can discuss medications with the pharmacist face-to-face. If they do buy from an Internet source, patients should choose vendors who subscribe to the standards of VIPPS (Verified Internet Pharmacy Practice sites).

The story is "Canadian drugs—a good deal?", which appeared in the North County Times, April 22, 2006, by Bradley J. Fikes. The full story is available here.

IHLS Executive Director Professor Bryan A. Liang Participates in Invitation-Only Group Meeting with Secretary of Health and Human Services Mike Leavitt

April 20, 2006 - IHLS Executive Director Bryan A. Liang was part of an invitation-only group meeting with Secretary of the Department of Health and Human Services Mike Leavitt during his stay in San Diego. Secretary Leavitt requested a meeting with select health care leaders in southern California to discuss a specific program of Medicare purchasing and quality reform that will be proposed by the federal government.

"Secretary Leavitt gave us an important glimpse of what is in store for the health care community in the near future," said Professor Liang. "The emphasis of the federal government in trying to coordinate information standards and business purchasing of health care products is intriguing, but of course the devil will be in the details. Issues of consumer education, the uninsured, patient safety, and other key areas are still to be detailed."

Leaders of the provider, pharmaceutical, and device industries as well as the business community attended the meeting. Professor Liang was the only academic representative invited.

Dr. Bryan A. Liang Gives Law and Ethics Lecture at School of Speech, Language & Hearing Sciences, San Diego State University

April 17, 2006 - Dr. Bryan A. Liang, Institute of Health Law Studies Executive Director, gave the presentation, "Conflict of Interest and the Rules of Audiology: Law & Ethics in Practice" at the School of Speech, Language & Hearing Sciences, College of Health and Human Services, San Diego State University.

"Understanding the rules of conflict of interest in law is important for professional practice purposes, but professional ethics also demands you assess conflict of interest situations to ensure that your practice that focuses on the patient's best interest," noted Professor Liang. "As the population ages, these considerations will grow in number and magnitude. Formulating policies and understanding laws now will assist you when these additional circumstances arise in the future."

Dr. Liang was invited to speak at the School by Jacque Georgeson, AuD, Co-Director of the Communications Clinic for Speech, Language, Hearing Disorders and Deafness at San Diego State University. For more information on the clinic, click here.

Bryan A. Liang, IHLS Executive Director, Interviewed by CNN Money for Vioxx Lawsuit Story

April 11, 2006 - In light of the recent punitive damages verdict of $9 million dollars against Merck for its product Vioxx, CNN Money interviewed IHLS Executive Director Professor Bryan A. Liang as to what the case may mean for the thousands of remaining lawsuits against the company pending in state and federal court.

"The dishonesty [displayed by Merck by withholding negative data from federal regulators] is now coming back to hurt it," said Dr. Liang. Looking forward to future cases, Dr. Liang said that great attention will be paid to the sympathetic nature of plaintiffs. He observed that John McDarby, who won the punitive damages in this case, was wheelchair-bound, while the co-plaintiff Thomas Cona, who did not win damages, was described in press reports as energetic.

"The big picture is going to depend on how the defendants are going to look, and how the plaintiff is being portrayed," said Dr. Liang.

Further, Dr. Liang noted that jurors stayed "well below" the punitive awards cap of $22.5 million, which is significant because in the first Vioxx trial in Texas, the jury awarded damages that were tenfold the state limit.

"The jurors don't want to seem excessive," said Dr. Liang. "Everyone seemed to think that the Texas verdict was excessive, and it hurt the cause [against Merck]."

The story is "Vioxx jury: Merck lied, must pay: No. 2 drugmaker vows appeal as jury awards $9 million in punitive damages related to painkiller," by Aaron Smith, CNNMoney.com reporter. The story is available here.

Professor Bryan A. Liang Gives Plenary Speech on Law, Professionalism and Ethics at American Academy of Audiology Annual Meeting

April 7, 2006 - Professor Bryan A. Liang, Institute of Health Law Studies Executive Director, gave the plenary speech, "Audiology, Law, and Ethics: Worries of the Near and Not-So-Distant Future," at the 2006 Annual Meeting of the American Academy of Audiology.

"Audiology is poised to move into the primary delivery sphere of health care, as the population ages in the next 25 years," noted Professor Liang. "But it must address both near term and not-so-distant future issues and make a fundamental decision: what model does the field wish to adopt? Does it wish to move to a doctoring profession, with a primary fiduciary duty to patients? Or does it wish to move towards a business ethics, retail model with a focus on a level playing field for competitors? The ethics and professionalism considerations for audiology will depend critically upon how it answers these questions."

Dr. Liang also participated in a panel discussion on ethics and professionalism issues with the Ethical Practices Board of the Academy. Included were Mike Metz, Patricia Harrington-Ganz, Jane Kulula as well as Professor Liang.

An interview with Dr. Liang on him and his presentation was featured in a special conference edition of The Hearing Journal, entitled "Audiology's at an ethical crossroads, says Dr. Liang, a man of many sides," by Sara Bloom.

Institute Executive Director Gives Plenary Presentation at American Academy of Neurology 2006 Annual Meeting

April 2, 2006 - IHLS Executive Director Professor Bryan A. Liang gave the plenary presentation, "A System of Medical Error Disclosure: Promoting Patient Safety Using a Partnership of Provider and Patient," at the 58th Annual American Academy of Neurology Annual Meeting in San Diego, CA. The presentation was part of the Patient Safety Colloquium entitled, "Communication in Patient Safety: It's a No-Brainer."

"Communication is an apt theme through which we can describe and improve patient safety using a partnership with our patients," noted Professor Liang, who is also a physician and Co-Director of the San Diego Center for Patient Safety at UCSD School of Medicine. "Disclosure of medical errors represents one of those times where sensitivity to patient and family needs is essential to both communicate effectively as well as obtain important system information to improve patient safety. Themes of policies and procedures to promote these goals include mutual respect, patient and provider education, clear procedures, disclosure objectivity, and early-intervention mediation."

Dr. Liang was invited to give the plenary presentation by Daniel M. Feinberg, MD, University of Pennsylvania, Thomas H. Glick, MD, Harvard Medical School, and Steve Rush, American Academy of Neurology.

IHLS Executive Director Bryan A. Liang Interviewed by CNN Money for Story on Pfizer Off-Label Lawsuit

March 28, 2006 - IHLS Executive Director Dr. Bryan A. Liang was interviewed and quoted by CNN Money regarding a lawsuit filed against Pfizer, Inc. The lawsuit, filed by the Welfare Fund of the Teamsters Union, charges that Pfizer illegally marketed their drug Lipitor for uses not approved by the FDA.

Dr. Liang noted that the Lipitor allegations of off-label marketing will be hard to prove. There have been previous instances of drug promotion by companies for completely different diseases than approved by the FDA. But here, "the distinctions aren't nearly as clear as with other cases. This is not an obvious attempt at applying the drug to something that's completely irrelevant." However, Dr. Liang said Pfizer faces a difficult situation: the company cannot settle, because that would encourage more lawsuits, but going to trial always carries the risk of losing, because sometimes the juries are biased against big business. "Juries can draw their own conclusions," said Dr. Liang. "Sometimes juries just want to get back at corporations. Going to trial is always a risk."

Dr. Liang was interviewed by Aaron Smith, CNN Money reporter. The story is "Pfizer gets an off-label message: Suit against drug maker over Lipitor prescription could be precursor as states, health plans look to save money," available here.

Professor Bryan A. Liang Appointed as American Bar Association Advisor to National Conference of Commissioners on Uniform State Laws

March 24, 2006 - Professor Bryan A. Liang, Executive Director of the Institute of Health Studies, has been appointed as the American Bar Association Advisor to the National Conference of Commissioners on Uniform State Laws. He was appointed to assist in drafting the Uniform Interstate Emergency Healthcare Services Act.

"Of course this is a distinct honor and privilege to be appointed as the American Bar Association Advisor to the NCCUSL," said Professor Liang in response to the appointment. "The NCCUSL's attention to the critical nature of interstate emergency health care services is laudable. Natural disasters such as Katrina and issues in terrorism response make uniformity in this area extremely important from public health and public policy points of view. I very much look forward to working with the Commissioners to draft a uniform act addressing issues associated with emergency services."

The National Conference of Commissioners on Uniform State Laws provides states with non-partisan, well-conceived and well-drafted legislation that brings clarity and stability to critical areas of the law. For more information, click here.

Dr. Bryan A. Liang Gives Patient Safety Presentation at Scripps Memorial Hospital Grand Rounds

March 21, 2006 - Dr. Bryan A. Liang, Institute of Health Law Studies Executive Director and Professor of Law, presented the patient safety lecture, "Patient Safety and Medical Error: Theory, Tools, and Applications" at the Medical Grand Rounds of Scripps Memorial Hospital, La Jolla, CA. Dr. Liang is also Co-Director and Associate Professor of Anesthesiology at UCSD School of Medicine.

"Promoting patient safety and reducing medical errors require us to try to reduce preventable errors, of course," said Dr. Liang. "But error-free action is impossible; to truly promote systems improvement in health care safety and quality, we need to accept that as humans, we will err, and that we need to seek to create systems resilient to this inevitable occurrence of human error."

The event was co-sponsored by Scripps Memorial Hospital and the Institute of Health Law Studies, California Western School of Law. It was the second lecture Dr. Liang has given at Scripps Memorial Hospital on patient safety.

Professor Bryan A. Liang Comments on Potential Post-Claims Underwriting Case in LA Times Story

March 20, 2006 - Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, was interviewed by the LA Times regarding a potential "post-claims" health insurance underwriting case. Raudel Rodriguez was denied health insurance coverage after believing he had been approved for insurance by Blue Cross of California. Mr. Rodriguez was interviewed for the policy in Spanish, yet the application sent to him for his signature was filled out in English. When he needed and obtained significant cardiac services, the company retroactively cancelled his policy. If this was done to simply avoid paying claims, it is termed "post-claims underwriting" and is an illegal practice.

Dr. Liang indicated that "the insurance company had a duty to investigate [Mr. Rodriguez's application]. If they didn't investigate ahead of time [to verify its accuracy], that's their problem." Dr. Liang also noted that post-claims underwriting, in combination with lanaguage barriers, affects minority, vulnerable, and poor populations the greatest. "These populations need the greatest protections," added Professor Liang.

The story is "Language Becoming an Issue for Health Insurers," by Lisa Girion, which appeard March 20, 2006, in the LA Times. It is available here.

IHLS Executive Director Professor Bryan A. Liang Appointed to the Asian & Pacific Islander American Scholarship Fund Application Review Board

March 8, 2006 - IHLS Executive Director Professor Bryan A. Liang was appointed to the Asian & Pacific Islander American Scholarship Application Review Board for 2006-2007. In this capacity, he will be evaluating scholarship candidates for APIASF.

"This is a wonderful opportunity to ensure that high quality young people are able to obtain higher education," said Professor Liang upon the announcement. "By providing these talented students the opportunity for higher education, hopefully we can empower them to make their voices heard in the community and in the political process, now and in the future."

APIASF's mission is "To forge partnerships building a national Asian and Pacific Islander American Scholarship organization that supports and encourages all Asian and Pacific Islander American students to pursue higher education, thereby developing future leaders who will contribute back to their communities, and ultimately, strengthening America." For more information, click here.

Professor Bryan A. Liang Presents on Law, Medicine, and Patient Safety at Scripps Mercy Hospital Medical Grand Rounds

March 7, 2006 - Dr. Bryan A. Liang presented at Scripps Mercy Hospital Medical Grand Rounds. His topic was "Breaking the Professional Paradigm: Moving Medicine and Law to Systems Safety Approaches."

"Medicine and law, traditional foes, actually cooperate to maintain a status quo in health care delivery that discourages patient safety improvement,"said Dr. Liang. "Open communications, partnerships in care, and empowering patients to be part of the safety improvement team are thwarted by traditional legal tort beliefs and traditional medical ethics. And both of these also result in few patients being compensated when injured by the system. A shift to a system of delivery improvement expands ethical mandates and would promote patient safety and quality improvement in health care."

The presentation was jointly sponsored by the Scripps Mercy Hospital and the Institute of Health Law Studies. Dr. Liang has presented at Scripps Mercy Hospital previously on other patient safety issues. He was invited to present again by Dr. David Shaw and Dr. Stanley Amundson, Scripps Mercy Hospital, who are both leaders in the facility's medical education program.

KPBS "Full Focus" Features Interview with Dr. Bryan A. Liang on Morales Case

March 6, 2006 - The KPBS News Program "Full Focus" interviewed Dr. Bryan A. Liang on the Morales death penalty case. He appeared with Dr. Edgar Canada, President of the California Society of Anesthesiologists to discuss the issue.

"Judge Fogel required that either a physician actually directly administer a dose of sedative to kill the condemned or that he or she must be in the execution chamber and order additional anesthetic to be given if Morales isn't 'adequately' sedated,"said Professor Liang. "Yet for an intelligent, informed judge to give the State only these options, which could never be fulfilled by physicians because it directly contravenes medical ethics, is quite astounding. It makes one wonder what the judge was thinking or if there isn't some subtle form of judicial activism going on here," observed Dr. Liang.

Morales was convicted of the rape and murder of 17 year old Terri Winchell in 1981 and sentenced to death. Morales has challenged the State of California's lethal injection protocol as cruel and unusual punishment in violation of the US Constitution. Morales' execution has been stayed and full hearings on the case will occur on May 2 and 3.

IHLS Executive Director Professor Bryan A. Liang Presents at Pharmaceuticals and the Internet Law Program

March 2, 2006 - IHLS Executive Director and Professor of Law Bryan A. Liang presented his work at the conference Pharmaceuticals and the Internet. The conference was part of the Albany Law Journal of Science & Technology Symposium, sponsored by Albany Law School. Professor Liang's presentation was "Weaknesses in Counterfeit Drug Detection."

"Many have placed their hopes on securing the safety of the drug supply on technology," noted Dr. Liang. "Yet these tools are not yet ready for prime time. RFID, DNA markers, color-shifting inks, and holograms all suffer from the same weakness: they merely track cardboard, not product," he observed. "To address the problem of counterfeits and weaknesses in the drug supply chain, we have to go beyond technology alone, and engage in a public health educational campaign that includes patients and providers, set up a stakeholder reporting system for epidemiologic and law enforcement purposes, as well as increase penalties to fit this heinous crime—including life imprisonment."

Dr. Liang was a featured speaker with other leaders in the area, including FDA Associate Commissioner for Policy and Planning William K. Hubbard, DEA Group Supervisor, Field Division Agent Carlos. M. Aquino, DEA Senior Diversion Investigator Agent Joseph X. Mendez, and IHLS Member and Partnership for Safe Medicines Executive Director James Class, PhD. Selected papers from the Symposium will be published in a forthcoming special issue of the Albany Law Journal of Science & Technology.

Dr. Bryan A. Liang Comments on Morales Case for"These Days" KPBS Radio Program

February 27, 2006 - Dr. Bryan A. Liang, IHLS Executive Director and Professor of Law, California Western School of Law, and Associate Professor of Anesthesiology, UCSD School of Medicine, was a guest on the KPBS radio program "These Days" to comment and answer listener questions on the Morales death penalty case. He discussed both the legal and the medical ethics perspectives of the situation. Michael Morales was convicted of raping and killing 17 year old Terri Winchell in 1983, but has challenged use of lethal injection as the means of his execution as cruel and unusual punishment in violation of the US Constitution's 8th Amendment.

"Legally, Judge Fogel was concerned about the potential for Morales to feel severe pain during the lethal injection procedure, which may constitute cruel and unusual punishment" said Dr. Liang. "Although this is a well accepted procedure across states with the death penalty, doubts from the medical literature as to the actual sedation of the condemned likely made the judge reconsider what should be required in Morales' case. Yet, from a medical ethics perspective, none of the alternatives he offered—having physicians in the room to increase the anesthetic if they deemed he was not appropriately sedated, or having a medical professional him or herself inject a massive dose of anesthetic to cause death—is permitted by medical or nursing ethical codes. So at this point, the families of the victims and those on death row are in limbo as to what will be done."

Dr. Liang was interviewed by Tom Fudge, host of "These Days." Excerpts of the interview can be heard here.

Professor Bryan A. Liang Presents at University of North Carolina School of Medicine on Parallel Trade in Pharmaceuticals

February 25, 2006 - Bryan A. Liang, Executive Director and Professor of Law at the Institute of Health Law Studies, California Western School of Law, presented his work at the University of North Carolina School of Law's Symposium, "Saving Profits, Saving Lives: A Comprehensive Discussion of the Social, Legal, and Economic Implications of Reverse Engineering and Parallel Importing on the Pharmaceutical Industry." His presentation was entitled, "Parallel Trade in Pharmaceuticals: Injecting the Counterfeit Element into the Public's Health."

"Parallel trade has been going on since time immemorial," said Professor Liang. "Whenever there is a difference in price across markets, humans will take advantage and arbitrage to make a profit. The same goes for pharmaceuticals. However, the problem is that on the way from one market to another, these drugs may be replaced or diluted with fakes, and there is no easy way to detect them. The EU, which has allowed parallel trade for some time, has now entered a period where counterfeit medicines are taking a toll on the health of its citizens. The Council of Europe, Interpol, the World Health Organization, and the European Commission are now trying to address these issues. We should learn from these experiences before adopting parallel trade in pharmaceuticals, or else we may import these problems into our own country."

Dr. Liang joined an illustrious group of presenters, including Jayashree Watal, India Representative of the World Trade Organisation, James Gathii of Albany Law School, Obi Aginam of Carleton University, Jerome Reichman of Duke Law School, and James Class, IHLS Member and Executive Director of the Partnership for Safe Medicines. A select group of papers from the conference will be published by the North Carolina Journal of International Law & Commercial Regulation.

Executive Director Professor Bryan A. Liang Comments on Morales Death Penalty Issues on KGTV News

February 23, 2006 - Bryan A. Liang, Executive Director of the Institute of Health Law Studies, was interviewed by Channel 10, KGTV News in San Diego about the medical and legal issues associated with the Morales death penalty. Morales was sentenced to death for the murder of a 17 year old in 1983. However, he is challenging the process by which his execution will be performed. The court ordered that anesthesiologists be present to ensure that Morales was appropriately sedated. However, these physicians withdrew from participating in the execution under the terms of the order.

"First, it is completely unethical for physicians to participate in executions," explained Professor Liang, who is a physician. "The primary tenet of medicine is first, do no harm. Clearly, if an anesthesiologist were to directly inject a person with a deadly material to assist in killing that person, such an act would violate this primary provision of medical ethics."

From the legal perspective, "this is a case more about the process of execution, rather than a whole hog challenge of the constitutionality of the death penalty," said Professor Liang, who is also an attorney. "The question to be answered in future hearings is whether it is cruel and unusual punishment to use a process that might, as Morales claims, result in him being awake and feel agonizing pain after the muscle and cardiac paralyzing agents are administered."

Professor Liang was interviewed by Michael Chen, News Reporter at Channel 10 News. For more information, click here.

Professor Bryan A. Liang Gives Health Care Contracting Presentation to Physician Residents and Fellows

February 15, 2006 - Professor Bryan A. Liang, Institute of Health Law Studies Executive Director, gave the presentation, "Above the Dotted Line ... The Basics of Health Care Contracts and Contracting" to University of California, San Diego School of Medicine residents and fellows. His presentation was part of the ongoing Resident Core Lecture Series.

"Health care contracts and contracting are not amateur sports," said Professor Liang. "You need to perform due diligence, prepare for negotiation, and really check out the terms of the deal. And you need to do this using a professional to protect your interests—a lawyer. It's too late once you've signed the contract, and find terms or obligations you don't think are fair or equitable."

Dr. Liang was asked to give this presentation by Cynthia Slaughter, Director of the University of California, San Diego School of Medicine Continuing Medical Education.

Executive Director Bryan A. Liang Gives Patient Safety Lecture to UCSD School of Medicine Class of 2006 and Participates in Safety Panel Discussion

February 13, 2006 - Bryan A. Liang, MD, PhD, JD, Executive Director of the Institute of Health Law Studies, California Western School of Law, and Co-Director and Associate Professor of Anesthesiology, San Diego Center for Patient Safety, UCSD School of Medicine, gave the lecture, "Patient Safety and Medical Error: Concepts, Tools, and Examples." He was asked to give this presentation as part of the University of California, San Diego School of Medicine "From Principles to Practice" seminar series.

"Outstanding people like those here today make errors," said Professor Liang. "Yet even the most conscientious, most careful, and most professional people make mistakes. This does not make them bad people or incompetent. Even the best of people cannot outperform the systems that bound and constrain them."

Professor Liang emphasized systems analysis and team efforts to promote safety, as has occurred in the aviation community. "Through the process of systems approaches and team analysis, we can see where the problems are, and then do something about them."

Professor Liang also participated on a panel discussion of "Patient Safety Narratives", where physicians told their own stories of medical errors and the personal impact upon them. Included on the pane were Gerry Boss, MD, Internal Medicine; Walter Olsen, MD, Interventional Radiology; Renate Pilz, MD, Internal Medicine; and Mark Pian, MD, Pediatrics.

Dr. Liang was invited to give his presentation and participate in the panel discussion by Dr. Renate Pilz, of the UCSD Department of Medicine.

Professor Bryan A. Liang Gives Lecture on Medical Privacy Law to Public Health and Preventive Medicine Audience

February 10, 2006 - Public health and preventive medicine students and physicians gathered to hear Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies and Co-Director of the San Diego Center of Patient Safety, lecture on the federal medical privacy provisions. His presentation was entitled, "HIPAA and the Public Health: Outlining Some of the Boundaries."

"Those involved in public health—physicians, public health professionals, and first responders—will be dealing with patient information. This is particularly true in situations of investigating and responding to natural and man-made disasters. Hence, they must know the provisions of the medical privacy laws under HIPAA as well as state law," Dr. Liang noted. "The scope of HIPAA, and its public health exception, does allow flexibility to do one's job. But those working in this area must understand the law's boundaries so as to respect patient rights while also protecting the public's health."

Dr. Liang was invited to speak by Dr. Chris Tsai, Chief Resident of the General Preventive Medicine Residency, UCSD School of Medicine.

Institute Executive Director Bryan A. Liang Interviewed and Quoted on Charity Hospital Lawsuits

February 9, 2006 - Institute of Health Law Studies Executive Director Bryan A. Liang was interviewed and quoted by Healthcare Risk Management on the topic of the class action lawsuits against charity hospitals by uninsured patients. The recent settlement of some of these cases has raised issues as to what may occur within the industry.

Dr. Liang noted that "People are going to start settling these [cases] because the costs are racking up. All the state cases are a little bit different, and no two hospitals are looking at the same situation, but when a large system ... settles, that has to give momentum to the plaintiffs and make other hospitals look harder at that option." He added that this is a tremendous public relations issue. "If your community sees you as a facility that is basically raping the uninsured consumer, then you are going to be seen as a big corporate behemoth that needs to be taken down. But if you are seen doing good things for people in the community, people aren't going to feel it is necessary to go after you. Your public image is everything."

Dr. Liang was also interviewed on the potential effects of the settlements on suits alleging that charity hospitals violated the Emergency Medical Treatment and Active Labor Act, which prohibits hospitals from asking patients about financial resources before they are given a medical screening examination and stabilized. Dr. Liang indicated that "Any appearance of impropriety can invite a closer look and fines. With the [charity] lawsuits creating this atmosphere, you don't want to play it that close to the edge." He added that risk managers must steer the entity clear from policies and procedures that may violate the law. "Risk managers have a responsibility to say that optimizing revenue can't always be the main concern, no matter how important that can be to the organization."

Dr. Liang's comments appear in Healthcare Risk Management, vol. 28, no. 1, 2006, in the articles, "System settles charity suit, and other payouts likely," p. 4-5, and "Look closely at EMTALA in light of Scruggs suits," p.6.

Executive Director Bryan A. Liang Presents at Globalization of Pharmaceuticals Symposium at Boston University School of Law

February 4, 2006 - Bryan A. Liang, MD, PhD, JD, Executive Director and Professor of Law, California Western School of Law, presented his work, "Fade to Black: Importation and Counterfeit Drugs," at the Globalization of Pharmaceuticals: International Regulatory Issues," held at Boston University School of Law. The conference was sponsored by the School of Law and the American Journal of Law and Medicine.

"This issue of importation and counterfeit drugs are inextricably linked, both from a policy perspective and a patient care perspective," Dr. Liang noted. "The counterfeit drug business is a $32-35 billion business now attracting organized crime and terrorist groups. Until the holes in the safety and regulatory structure are filled, allowing for importation may import the problems the rest of the world has experienced with parallel trade into our own. It's not a chance we should take for our loved ones."

Dr. Liang's comments will be published in a forthcoming Symposium of the American Journal of Law and Medicine. Dr. Liang is also Co-Director of the San Diego Center for Patient Safety, UCSD School of Medicine, Adjunct Associate Professor of Public Health, San Diego State University College of Health and Human Services, and Adjunct Professor of Aviation at Western Michigan University. He was invited to give his presentation by Professor Fran Miller, Boston University School of Law.

Institute of Health Law Studies Granted Unprecedented Four Year Re-Accreditation for CME Activities by Institute for Medical Quality

February 2, 2006 - The Institute of Health Law Studies today was granted an unprecedented four year CME re-accreditation extension by the Institute for Medical Quality of the California Medical Association.

The Institute of Health Law Studies is a pioneer in professional education, being the first law school center in the US to be accredited to grant continuing medical education, doing so in a record four months of activities. The standard period is traditionally at least one year of planning and events.

IHLS has continued its pioneering role in its re-accreditation. Most re-accreditation applications, if they are successful, obtain two year extensions at most. However, on the basis of the excellence and innovative programs demonstrated during the IMQ site visit and survey, upon recommendation of the survey team and assessment by the full IMQ board, IMQ granted IHLS the maximum re-accreditation period—four years.

Dr. Bryan A. Liang, Executive Director of the Institute of Health Law Studies commented upon the IMQ announcement. "Of course, we are elated that IMQ recognized the quality and excellence of our educational activities. This maximum extension period grant is unprecedented for a new program that has been in operation for only one year, and indeed is uncommon even for established programs." Dr. Liang added that "this momentous goal could not have been accomplished without the hard work and abilities of the Institute's CME committee, which I am fortunate to chair. The members of the committee are Ms. Laura Lin, Ms. Arlene Luu, Ms. Pam Tait, as well as public member Ms. Shannon Biggs. They are to be congratulated for a job well done."

For more information on the Institute of Health Law Studies, click here. For information on the Institute for Medical Quality, click here.

Dr. Bryan A. Liang Addresses the 42nd Annual Society of Thoracic Surgeons Annual Meeting

January 27, 2006 - Dr. Bryan A. Liang, Executive Director and Professor of Law, Institute of Health Law Studies, California Western School of Law, and Co-Director and Adjunct Associate Professor of Anesthesiology, University of California, San Diego School of Medicine, addressed the Society of Thoracic Surgeons 42nd Annual Meeting in Chicago, Illinois. He was part of a special presentation section of the meeting, the Patient Safety Town Hall. His presentation was entitled, "Law’s Promise: The Patient Safety and Quality Improvement Act of 2005—Implications for Thoracic Surgeons."

"The Patient Safety and Quality Improvement Act of 2005 heralds a new era in patient safety and quality improvement in the United States," said Dr. Liang. "For the first time, information and discussions about quality and safety issues can move across narrow committee and institutional lines—something the law has prevented for decades. Now, we have the opportunity to share information for its intended use—improving the health delivery system, rather than having this information used against providers in lawsuits."

Dr. Liang was invited to address the Society of Thoracic Surgeons by Dr. Blair Marshall, Chief of the Division of Thoracic Oncology at Georgetown University Hospital.

Professor Bryan A. Liang Gives Professionalism and Ethics Lecture at 13th Annual Illinois Academy of Audiology Conference

January 27, 2006 - Professor Bryan A. Liang, Executive Director of the Institute of Health Law Studies, gave the lecture "Audiology and Professionalism: The Intersection of Ethics and Law" at the 13th Annual Illinois Academy of Audiology Annual Meeting in Chicago, Illinois. The theme of the conference was "Professionalism at Its Best."

"Professionalism does not follow the 'drivers test model', which looks to the lowest acceptable level of behavior," said Professor Liang. "Instead, professionalism seeks excellence in all aspects of professional action. The law, on the other hand, generally only follows the drivers test model. One should never assume mere adherence to the law constitutes professional behavior or professionalism at its best."

Dr. Liang was invited to speak to the Illinois Academy of Audiology by Karyn Malesevic, Au.D., Co-Chair of Education for the Illinois Academy of Audiology. The Illinois Academy of Audiology Annual Convention is one of the largest state audiology conventions in the United States. Dr. Liang spoke to the Academy last year, and was brought back this year by the Academy's leadership "by popular demand."

IHLS Executive Director Bryan A. Liang Receives Community Service Recognition and Appointed to Board of Directors at Pan Asian Lawyers of San Diego Annual Awards Dinner

January 13, 2006 - The Pan Asian Lawyers of San Diego recognized Institute Executive Director and Professor of Law Bryan A. Liang for his community service to the Pan Asian Lawyers of San Diego. Dr. Liang was also sworn in as a member of the Board of Directors of PALSD. The Pan Asian Lawyers of San Diego is dedicated to advancing Asian Americans in the legal profession, promoting and advocating the interests of the Asian Pacific American community, and preserving the culture, heritage, and diversity of the community.

"I am of course humbled and honored that the Pan Asian Lawyers of San Diego would recognize any work that I might have done that would assist their efforts, since PALSD has such a significant impact on the Pan Asian and broader community," said Professor Liang. "I am also delighted that the organization has the confidence in me to appoint me to their Board. I look forward to promoting the outstanding work and impact Pan Asian Lawyers of San Diego has to further the interests of vulnerable populations."

For more information on the Pan Asian Lawyers of San Diego, click here.

Institute Members Give Community Law School Presentations on Elder Abuse

January 11, 2006 - Institute of Health Law Studies Executive Director Bryan A. Liang, and Institute Research Associates Laura Lin, RN, MBA, JD, and Arlene D. Luu, BSN, PHN, JD, presented a public information session on financial elder abuse, signs and symptoms of elder abuse, and reporting methods to support prosecution and detection of elder abuse. The forum was Community Law School, a public venue where members of the legal community provide important information to the public on key community issues involving legal rights and protections.

Professor Liang's presentation was entitled, "Learning the Suspect: Determining the Signs and Symptoms of Elder Abuse," in which he discussed questions and observations that community members can ask and make to detect clues tofo potential elder abuse. Ms. Lin's presentation was entitled, "Older Adults and Financial Abuse," where she outlined the many different ways that seniors can be cheated and defrauded, and means by which to protect against such activities. Finally, Ms. Luu's presentation was entitled, "Elder Abuse Reporting," in which she provided the legal definitions of elder abuse, and California contact information to report suspected cases of abuse.

Professor Liang, Ms. Lin, and Ms. Luu were invited by Ms. Myrna Pascual, former President of the Filipino Lawyers Association and Pan Asian Lawyers Association, to present at Community Law School. The Community Law School is a joint service activity of the Southwest Center for Asian Pacific American Law, the Pan Asian Lawyers of San Diego, and the Filipino Lawyers of San Diego, and is supported by a grant from the San Diego County Bar Association. For more information, click here.

Institute Healthliners

Institute of Health Law Studies Given Alpha Project Service Appreciation Award

Professor Liang Interviewed by Lawyers USA on Botox Trials

KPBS Interviews Professor Bryan Liang on Congressional Investigation of Health Insurer Practices

Executive Director Bryan A. Liang Comments on Botox Verdict in the Los Angeles Times

Voice of America Interviews Professor Bryan Liang on Counterfeit Medicines

Executive Director Bryan A. Liang Comments on Bipartisan Healthcare Summit

KPBS Interviews Professor Bryan A. Liang on Transplant Denial Case Against Blue Cross

Professor Bryan A. Liang Interviewed on New Obama Healthcare Proposal

Daily Journal Interviews Professor Bryan Liang on Google Policy Change for Online Drug Seller Advertisements

Executive Director Bryan A. Liang Interviewed by KCBS on Report of High Insurer Profits and Questionable Insurer Activities

Professor Bryan A. Liang Interviewed in Los Angeles Times Story on Indictment of Michael Jackson’s Physician for Involuntary Manslaughter

IHLS Executive Director Bryan Liang Interviewed on “Dual Track” Healthcare Reform Strategy

IHLS Sponsors San Diego Blood Mobile

IHLS Hosts San Diego Network of CME Professionals Quarterly Meeting

6th Annual Warm a Heart Clothes Drive Begins

IHLS Honored as Member-at-Large Auxilliary Volunteer at Rady Children’s Hospital Annual Meeting

Professor Bryan A. Liang Interviewed by KCBS on California Health Care Single Payer Bill

Professor Bryan A. Liang and Research Associate Tim Mackey’s Science Paper Featured in North County Times

IHLS Sponsors Two H1N1 Flu Vaccine Clinics on campus January 20, 2010.

IHLS Executive Director Bryan Liang Gives “Pay-for-Performance” Presentation at 2010 UCSD Anesthesia Update Conference

Los Angeles Times Quotes Professor Bryan Liang on Insurance Rescission Appeals Court Case

Professor Bryan Liang Interviewed by KCBS on Senate Healthcare Reform Vote

Professor Bryan A. Liang Publishes Opinion Editorial in Forbes on Drug Importation

San Diego Business Journal Interviews Professor Bryan Liang on Genetic Information Nondiscrimination Act Weaknesses

IHLS Sells Raffle Tickets to Benefit Rady Children’s Hospital

Executive Director Bryan A. Liang Gives Emergency and Disaster Preparedness Presentation at Rady Children’s Hospital Advanced Trauma Symposium

Professor Bryan Liang Comments on Pharmaceutical Pricing Case in KCBS Interview

IHLS and HLS Representatives Appear in San Diego Blood Bank Public Service Commercial

Professor Bryan Liang Interviewed by KCBS on Senate Abortion Amendment

Executive Director Bryan A. Liang Gives Pharmaceutical Pricing Presentation at UCSD Rady School of Business

KCBS Interviews Professor Bryan Liang on COBRA Subsidies Program Termination

Professor Bryan A. Liang Appears on UCSD Graduate Program Information Media

Executive Director Professor Bryan Liang Quoted in Washington Post Article on Counterfeit Drugs

Daily Journal Interviews Professor Bryan Liang on Disability Insurance Story

San Diego Union Tribune Publishes Health Reform Opinion Editorial by Professor Bryan Liang

International Society of Pharmaceutical Engineers Annual Meeting Features Professor Bryan Liang

Professor Bryan A. Liang Discusses Law and Medicine Issues at UCSD School of Medicine

Drug Topics Features Comments on Health Care Reform and Importation by Bryan A. Liang

Executive Director Bryan A. Liang Gives Patient Safety and Transparency Lecture at UCSD

Professor Bryan A. Liang Gives Global Health and Pharmaceutical Issues Presentation

KGTV-ABC !0 News Interviews Professor Bryan A. Liang on Counterfeit Tamiflu

WFRU Interviews Professor Bryan A. Liang on Public Option Proposal

84WHAS Discusses Health Care Reform Options with Professor Bryan A. Liang

IHLS Participates in Kids' News Day for Benefit of Rady Children's Hospital

CKTB Canada Discusses Health Care Reform with Executive Director Bryan A. Liang

KMJ News Interviews Professor Bryan Liang on Health Care Reform and Patient Access

San Diego Business Journal Quotes Professor Bryan A. Liang on Healthcare Reform Concerns

KCBS Radio Interviews Professor Bryan A. Liang on Access to Care Issues in Health Care Reform

Bryan A. Liang and Judith McCarter Publish Perspectives Pieces on Fraud and Abuse Compliance

KIRO Seattle Discusses Health Care Reform with IHLS Executive Director Bryan A. Liang

Los Angeles Times Interviews Professor Bryan A. Liang on Adequacy of Healthcare Reform Efforts

San Francisco Daily Journal Quotes Professor Bryan A. Liang on Disability Insurer Story

Professor Bryan A. Liang Joins Editorial Board of Drug Topics

IHLS and HLS Reaches San Diego Blood Bank Life Level Four Member with Most Recent Blood Drive

Congressional Quarterly Researcher Story on Prescription Drug Abuse Features Comments by Professor Bryan A. Liang

Los Angeles Times Interviews Professor Bryan Liang on Transplantation Coverage Article

IHLS Participates in 3rd Annual Rady Children's Hospital Shamu and You Family Walk

Executive Director Professor Bryan A. Liang Gives Emergency Public Health Powers Presentation

San Francisco Daily Journal Article on Pharmaceutical Executive Conviction Quotes Professor Bryan Liang

Executive Director Professor Bryan A. Liang Quoted on KPBS Story on California Gender Rating Bill

IHLS Joins the Rady Children’s Hospital Miracle Makers Celebration at Humphrey’s by the Bay

Nature Biotechnology Interviews IHLS Executive Director Bryan A. Liang on Biotech Drug Safety

IHLS Provides Assistance to the Steve Open 6th Annual Tower Glass Golf Tournament

WBAL Radio Interviews Professor Bryan Liang on Novel H1N1/A Swine Flu Issues in Schools

IHLS Partners with Rady Children’s Hospital in Cancer Care Center Fundraiser

Bankrate.com Article on Student Health Insurance Quotes Professor Bryan A. Liang

National Committee on the Prevention of Elder Abuse Appoints Professor Bryan Liang to Research Proposal Review Committee

Executive Director Bryan A. Liang Quoted in Story on Governor's Line Item Vetoes

San Francisco Daily Journal Article on Pharmaceutical Executive Trial Quotes Professor Bryan A. Liang

Professor Bryan A. Liang Publishes San Diego Union Tribune Opinion Editorial on Insurance Regulations

Research Associate Tim Mackey and Executive Director Bryan A. Liang Publish Op Ed in San Francisco Daily Journal on Climate Change Technology Transfer

Executive Director Bryan A. Liang Interviewed by National Public Radio on Michael Jackson Story

IHLS Reaches “Group Difference Life Level Three Member” Status with San Diego Blood Bank

WBAL Interviews Professor Bryan Liang on Swine Flu and Vaccination Programs

Los Angeles Times Story on Michael Jackson Death Quotes Professor Bryan Liang

IHLS and HLS Hold Blood Drive for San Diego Blood Bank

Professor Bryan A. Liang's Paper on College Health a Top Ten Downloaded Paper in Multiple Categories

IHLS 5th Annual Erizen Sei Bowles Feed A Friend Food Drive Begins

Federal Trade Commission Study on "Authorized Generics" Features Research by Professor Bryan A. Liang

IHLS Sponsors Two H1N1 Flu Vaccine Clinics on campus
January 20, 2010.