Advancing U.S.-India Synergy In The Health Care Sector

Editor: Please tell us about your background and professional experience.

Maniar: I was born in India and raised in Bombay (now Mumbai) until the age of 13 when my family emigrated to the United States. I received my B.A. from Rutgers University in 1995 and my J.D. from Georgetown University Law Center in 1998. Given my upbringing in Mumbai and my legal training in Washington, D.C., I came to appreciate the value of diversity and thought that a career in transactional law would enable me to interact with legal and business professionals from diverse backgrounds. I also knew that I wanted to be involved in the growth and development of the Indian economy as part of my career. Luckily for me, as my interest in this area grew, so did the abundance of business with India. I thought it was important to start by building a strong foundation in general corporate law, which is what I practiced at a firm in DC after law school. Four years later, I moved to New York and joined the Health Care and Life Sciences practice of Epstein Becker & Green, P.C. ("EBG") where I continue to practice transactional law but with a focus on the health care and life sciences industry. I believe that there is a high level of potential synergy between the health care and life sciences industries in the United States and in India.

Editor: What were the factors that led to your decision to join EBG?

Maniar: EBG provided an opportunity for me to continue to do high quality transactional work while focusing on a dynamic industry that has been growing at an incredible rate and has become an increasingly important and influential sector in our national economy. Being married to a surgeon, I also wanted to learn more about the challenges and the pressures that physicians and their patients in this country face today. EBG also seemed like a great place to work, where I would receive good mentorship, grow professionally and be an entrepreneur, expanding my corporate practice within an organization that had already made its mark. EBG also values diversity, which is reflected not just in its associate ranks but among its leadership. It has a large number of minority and women partners for a firm of its size. In short, I was attracted to EBG for its national reputation in the health care and life sciences field, its commitment to diversity and mentorship and its collegial atmosphere, and it has proven to be a great choice for me.

Editor: How did you come to be involved with the North American South Asian Bar Association? What are some of the goals of this organization?

Maniar: I have been involved in the South Asian bar ever since I entered law school in 1995 and before it was even formalized at the national level, I was President of the South Asian Law Students Association during my last year at Georgetown Law. Following graduation, I served in various leadership positions with the DC and the New York chapters of the South Asian bars. Having experienced the value of participating in a close-knit bar association, it was a natural step for me to become involved in NASABA shortly following its inception in early 2003. I served first as a Director and am currently a member of the Executive Committee of the association. Earlier this year, I founded and am co-chair of the Business Law Section. I also assist our Corporate Counsel Committee, which is being spearheaded by colleagues who are senior corporate counsel at GE and Pfizer. I am also going to lead the Governance Committee during the 2007-2008 term.

NASABA's membership is comprised of local South Asian bar chapters throughout the country and in Canada. NASABA's goals include supporting and being a resource for the existing local chapters and developing new local chapters, providing a networking forum for all attorneys of South Asian background as well as attorneys who are interested in business and issues related to South Asian countries, promoting the professional development of South Asian attorneys and law students, and educating and disseminating information to the South Asian American community about the law, legal access, and relevant legal issues.

Editor: Give us examples of specific programs NASABA has undertaken to achieve its goals.

Maniar: In addition to the Business Law Section and Corporate Counsel Committee, we also have a Litigation Section, an Intellectual Property Law Section and a Public Interest Law Section to advance the professional development of individual members of its chapters.

NASABA's Judicial Evaluation Committee recently supported the appointment of three South Asian American members to the bench, two in Illinois and one in Massachusetts.

With regard to community issues, NASABA meets regularly with representatives from the Department of Justice, the Department of Homeland Security, and other federal agencies to discuss issues affecting the South Asian community, including domestic surveillance, the Patriot Act, immigrant registration, hate crimes and racial profiling. NASABA's Criminal Justice Committee developed and conducts a multi-city Convenience Store Outreach Program, the first effort of its kind to educate South Asian convenience store owners and employees on their responsibilities and potential liabilities under the laws regulating the sale of precursors to methamphetamines so they know what to look for when somebody comes in and buys unusual quantities of household items. The Committee also monitors acts of hate crimes and racial profiling in local communities and works with its local chapters to outreach to local law enforcement.

Editor: Please tell our readers about the upcoming conference.

Maniar: NASABA's largest annual event is its annual convention, which is hosted in a different city each year by the local chapter in the city and brings together practitioners, academics and law students from around the country for a three day program. This year's convention, entitled "Bridging Borders," is being hosted in San Francisco by our Northern California chapter from June 28-30, 2007. We will have over two dozen panels, several of which will focus on the theme of cross-border relations between the United States and India, Pakistan and other South Asian countries. Notable confirmed speakers this year include four federal judges, two U.S. attorneys, the General Counsel of Cisco and the General Counsel of First Republic Bank. The conference will be of interest to legal practitioners as well as other professionals interested in South Asian-American affairs. Registration is currently open at

Since MCC is targeted to reach corporate counsel, I should mention that our Corporate Counsel Committee is organizing two relevant panels this year. The first one will focus on outside counsel relationships and emerging trends and will discuss innovations in corporate-counsel selection criteria and billing arrangements with outside law firms. The speakers will include corporate counsel from Sun Microsystems, Dupont, GE, and Pfizer, who will be talking about their partnerships with preferred law firms. The second panel will focus on pitching for business to general counsel and includes the GCs that I mentioned before. The committee will also host a private reception for corporate counsel at the convention.

Editor: What are some of the key challenges and opportunities for NASABA currently and in future years?

Maniar: I believe that as a voluntary bar, NASABA's biggest challenge as well as opportunity is responding to and leveraging the current level of interest in South Asian affairs given the breakneck economic growth in that region. Also, it is important to focus on providing access to pro bono legal services as needed within the South Asian American community.

Editor: How does your practice at EBG intersect with the work of NASABA?

Maniar: Being involved in NASABA allows me to exchange information and ideas and share resources with other practitioners involved in the US-India business corridor and stay current on developments in this area. As a result, I can also be a resource to members of EBG who are representing clients doing business in India. Also, NASABA was a partner in EBG's program on outsourcing in the health care sector almost two years ago. As I mentioned earlier, I believe that there is a high level of potential synergy between the health care and life sciences industries in the United States and in India. EBG has been at the forefront of legal issues in this industry in the United States and continues to be at the forefront of the trend towards globalization in the industry. In addition, two of our other core practices, labor and employment and business law, also regularly advise clients with an international workforce who are doing business in India. EBG is a sponsor of the upcoming NASABA convention.

Editor: To what extent does the Health Care and Life Sciences Practice at EBG work with health care companies seeking to outsource services to India and other Asian destinations?

Maniar: We regularly advise health care and non-health care clients seeking to benefit from the potential cost efficiencies and competitive advantages presented by outsourcing certain operations. We are planning a program in the fall for our clients entitled "Globalization in the U.S. Health Care Industry: Outsourcing and Medical Tourism" to advise our clients on legal and business issues in these areas. We also advise Indian companies entering into outsourcing relationships with companies in the United States with respect to U.S. law issues.

Editor: What types of services are health care companies outsourcing to these destinations?

Maniar: As with many other industries, health care companies often outsource their IT development and integration functions. There are also many business processes and back office functions that health care companies can outsource, such as claims processing and credentialing, if it is a managed care company or billing, coding and medical transcription if it is a hospital. Pharmaceutical companies conduct much of their research and development activities outside of the United States. Also, although it is not technically outsourcing, there is an increasing interest among employers and managed care companies in medical tourism, the practice of traveling abroad for medical treatment.

Editor:What challenges do companies face when transferring operations abroad and how does the firm assist in this process?

Maniar: The risks include those that are involved in transitioning and having non-core functions performed by an outside provider, whether domestically or abroad. In addition, when transferring operations abroad, companies also have to navigate a different legal system and business culture. For example, the difference in legal regimes could have an impact on the way intellectual property in the transaction has to be protected or the way disputes in the relationship need to be resolved. EBG advises its clients in structuring and negotiating comprehensive business arrangements that cause the parties to think through and address various business contingencies and the impact of the difference in legal systems.

Editor: How can companies ensure compliance with privacy concerns, including HIPAA requirements, when outsourcing back-office functions to India and other South Asian countries?

Maniar: Companies should ensure continued privacy protection of their outsourced functions through comprehensive due diligence of the systems and processes of their outsourcing provider and strong contractual protections such as comprehensive audit rights and regular reporting requirements. If the company is a covered entity under HIPAA, it should enter into a business associate agreement with the outsourcing provider if the outsourcing provider will have access to protected health information. Some things that a reliable outsourcing provider to a health care organization should be able to demonstrate during due diligence are that it is compliant with applicable industry privacy and security standards, has a full-time HIPAA officer designated for policy implementation, conducts staff training and monitoring, has restricted access and downloading ability of its outsourced information and has strict confidentiality agreements with its employees.

Editor:What of the future? Where would you like to see the health care and life sciences practice in five years?

Maniar: I would like for our health care and life sciences practice to continue our tradition of being at the forefront of legal issues facing the health care industry by becoming a leader in the movement towards the globalization of health care. I plan to contribute to EBG's progress through my involvement in organizations like NASABA and by focusing on synergies in health care in the U.S.-India business corridor.

Published June 1, 2007.