Institute Healthliners

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.

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.