Success in Regulatory Compliance
- Prepared and delivered institutional and practitioner
HIPAA Privacy Training, compliance implementation guide,
policies and procedures and forms. Prepared and implemented
gap analysis for regulatory compliance
- Designed and implemented corporate compliance plans
at major hospitals. Organized system of analysis and
training on relevant regulatory changes such as HIPPA,
OIG and DOJ opinions and Medicare Conditions of Participation.
Focused on proactive audit, investigation and remediation
of issues
- Designed and implemented Privacy Officer role for
seller of web-based electronic medical records software;
analyzed and designed compliance with HIPAA for managed
care company with 250,000 enrollees
- Negotiated substantial reductions in initial fines
levied and penalties imposed by IDPA and IDPH in DOJ
and HHS reimbursement audits and discrimination claims
- Drafted application, policies, procedures and supporting
documents to convert pre-PACE non-profit organization
to PACE Provider (dual waiver status)
- Prepared third party administrator flexible spending
account plan documents to achieve compliance with ERISA
and DOL regulatory amendments
- Analyzed and drafted medical staff by laws to conform
to federal and state law and regulation
Acquisitions, Affiliations and Sales Agreements
- Negotiated the sale of a hospital corporation, including
completion of due diligence, negotiation and drafting
of asset purchase agreement, sale of interests in for
profit and nonprofit subsidiary insurance companies
and clinical service providers, contractual assignment
of equity and corporate member interests
- Led the sale of closely held preferred provider organization,
valuation of enterprise and residual interest in goodwill
- Acquisitions and sales of medical practices and shareholder
interests
- Advised hospital on sale and purchase of professional
services, clinical equipment and intellectual property
interests
- Established a joint venture to market intellectual
property
- Led acquisition of home health agency
- Created comprehensive affiliation agreement between
health system and rural primary care hospital
- Drafted graduate and undergraduate medical and nursing
educational agreements
Risk Management and Litigation Management Assignments
- Reduced self-insurance exposure of a major healthcare
provider in Cook County from $3 million to $1 million
per occurrence and maintained that level of exposure
- Reduced malpractice and general liability costs for
a major healthcare facility in Cook County by $8 million
- Decreased individual malpractice premiums for physician
members of a PHO in Cook County by forming a cooperative
program between the physicians\' malpractice insurer
and the hospital\'s Quality and Risk Management Programs
- Developed and managed a comprehensive risk management
program with a high-risk patient population which met
and exceeded expectations of the hospital
- Coordinated defense strategy between management and
outside counsel to achieve business goals of hospital
- Maintained comprehensive potential litigation database
for Medical Center identifying claims prior to filing
- Produced Risk Management handbook for Medical Center
staff and developed competency tests and training for
employees
- Managed to settlement or trial over 500 suits in
medical malpractice, product liability, including drug
and medical device cases; breach of contract including
service mark and copyright infringement, warranty and
insurance coverage; employment litigation in race, age,
disability and sexual preference claims; lead plaintiff
in AHA Asbestos suits and IAHA Medicaid rate litigation
- Provided defense of hospitals and physicians in Medical
Staff disputes and negotiations
- Reviewed and resolved adverse claims by insurers
and IDPR
- Managed insurance coverage disputes and bad faith
claims
- Provided mediation and settlement negotiation of
complex litigation and threatened litigation
- Negotiated settlement of class action race discrimination
suit
- Successfully defended petition to organize and unfair
labor practice charge by employed physicians
- Researched and gathered information on plaintiff\'s
expert witnesses
- Drafted an administered Self-Insurance Trust Fund
for hospital and professional liability indemnification.
- Accomplished 17 per cent expense to indemnity ration
over ten-year period
- Achieved over 75 per cent rate of success on appeal
Blumenthal
| Jarasek | Malecki
| Nieslawski
| Stroka | Tasch
Health Plans and Managed Care Projects
- Completed HMO, PPO and PPA subsidiary filings with
Department of Insurance, including several Mediplan
Plus filings; reviewed and negotiated all contracts
with IDPA for HMO subsidiary
- Ensured all aspects of state and federal compliance
of three insurance subsidiaries
- Drafted and reviewed managed care contracts
- Conducted grievance committee hearings as counsel
to hospital owned HMO and advised on coverage issues
Strategy and Transactions in Intellectual Property
/ Licensing
- Drafted, reviewed and negotiated contracts for hardware
and software acquisition and licensing
- Led analysis and implementation of privacy and security
measures for information systems to ensure HIPPA compliance
- Conducted training on privacy and security issues
concerning use of new software applications
- Reviewed and interpreted legislation concerning electronic
signature; provided analysis to ensure regulatory compliance
- Negotiated and drafted third party, reseller and
VAR agreements, escrow agreements, development and business
consulting agreements
Representative Experience in Human Resources
and Employment Law
- Advised Board of Directors and management on employment
law
- Reviewed medical staff issues and grievances
- Negotiated executive employment contracts and compensation
packages, including stock options and terms of severance
- Conducted physician recruiting
- Drafted and negotiated separation agreements with
corporate officers and senior managers
- Prepared and implemented employee handbooks, policies,
procedures, job descriptions, grievance processes
- Conducted training for management and staff on full
range of employment law subjects
- Drafted Employee Handbook
- Drafted and administered self funded ERISA plans
and adjudicated grievances
Research and Analysis to Solve Problems and Achieve
Client Goals
- Performed extensive Internet research
- Provided articles and advisories for Medicare and
Medicaid, health care fraud and abuse publications
- Researched and drafted memoranda concerning liability
issues of healthcare decision making for clinical providers
- Drafted appellate briefs, motions and orders in medical
malpractice, employment and commercial litigation
Corporate Law
- Legal Audits – monitor and review quality, communication,
cost-effectiveness, appropriate relationships, business
contracts, preventive capabilities
- Corporate governance and structure
- Advice and counsel to Board of Directors, Committees
of the Board and executive management
- Prepare Audit Committee and Compensation Committee
Charters
- Creation of business contracts and forms
- Negotiate, document and close mergers, acquisitions
and dispositions of businesses
- Negotiate, document and close strategic alliances
and joint ventures
- Creation of or review corporate titles for officers
and managers
Corporate Secretarial Functions
- Board, Committee and stockholders notices, agenda
and minutes
- Organize and coordinate annual shareholders meeting,
including solicitation of proxies and legal requirements
- Create, maintain and retain all appropriate corporate
records
- Oversee Investor Relations Function
- Compliance with ethics laws
Securities Law
- Create, structure and prepare public offerings of
securities
- Create, structure and prepare private placements of
securities
- Prepare or review Exchange Act reports, including
proxy statements
- Advice regarding Sarbanes Oxley, SEC and stock exchange
compliance
- Response to SEC or stock exchange inquiries
- Benchmark your company’s processes against executive
certification and other securities law requirements
- Provide advice on disclosure issues, and financial
analysts calls
Litigation and Professional Licensure
Defense
- Representation of physicians and healthcare providers
for informal conferences and administrative hearings
- Extensive experience with the Illinois Department
of Professional Regulation
- Administrative proceedings before regulating bodies
including federal and Illinois state governments
- Personal injury litigation, including commercial
torts
- Contract disputes, focusing on business and commercial
transactions
- Mediation, arbitration, settlement negotiations
Business Consulting
- Strategic planning and marketing for small and midsize
businesses, including physician practices, multispeciality
groups, ancillary providers
- Assistance and guidance with business start-ups, from
strategic planning to business roll outs
- Business transitions, including employment to independent
models, independent to employed models, assistance with
growth and change
- Developing physician practice models including private
groups and Independent Physician Associations ("IPA's")
- Reimbursement and technology expertise, including proof
of modeling and integration tactics
Malecki
| Hoffman | Vigilante
| White | Simonson
| McCarty | Nieslawki
|
|
Business
Consulting Services
