Tell us about your practice.
I primarily represent healthcare providers in manage care disputes, risk management, and professional liability matters. I advise my clients during the pre-litigation phase in attempts to negotiate favorable results without taking legal action. I also handle arbitration and litigation matters on behalf of providers against third party payers, requiring in-depth research, briefing, and analysis of complex legal issues, such as ERISA preemption, the Affordable Care Act implementation, and various state laws concerning "any willing provider" provisions.
What are some trends you are seeing related to the legal industry or in the industry in which you practice?
The passage of the Affordable Care Act has affected all stakeholders in the healthcare industry – patients, providers, and payers. Given the finite resources and infinite demands on the healthcare system, payers have become more aggressive by creating narrow networks, taking hard positions in contract negotiations, adopting restrictive claims handling policies and procedures, and raising premiums, all while lowering payments to providers. Healthcare providers should be aware of the common payment challenges that third party payers are lodging. Providers need to understand their rights and avoid costly mistakes to obtain proper reimbursement for their services. Providers should develop an offensive strategy to protect their business interests and prepare for the impact that lengthy payment delays may have on their revenue stream. They should also factor in the role that patients can play in resolving these disputes and look to patients as their allies.
How did your recent trip to Cuba to observe the country's healthcare system affect your practice?
Witnessing firsthand how a healthcare system can operate with very limited resources and still manage to take proactive steps to address common healthcare needs inspired me to think more creatively about the problems that my clients face. Even the most complicated issues can be resolved by identifying common goals and creative solutions.