- October 30, 2024
- EVENTS
Garfunkel Wild's 11th Annual ASC and Health Care Management Virtual Symposium is dedicated to the most important business, legal, clinical, and operational issues facing the ASC and health care management community.
Biography
Alison Schimel joined Garfunkel Wild, P.C. in 2022. She advises clients on a host of general commercial and regulatory matters. Alison’s practice will focus on counseling clients with respect to managed care contracting and health care delivery models.
Prior to joining Garfunkel Wild, Alison worked as an Assistant Vice President at National Health Resources, where she oversaw and managed the physician consulting services division of the company, along with local IPA and PO. She has experience in the implementation of value-based contracts and worked closely with payers and practices in developing workflow processes to help physicians achieve the quality and financial goals set before them. Her work with smaller physician practices provided insight into the practical challenges that can arise as practices attempt to maintain compliance with new regulatory requirements.
Prior to joining Garfunkel Wild, Alison worked as an Assistant Vice President at National Health Resources, where she oversaw and managed the physician consulting services division of the company, along with local IPA and PO. She has experience in the implementation of value-based contracts and worked closely with payers and practices in developing workflow processes to help physicians achieve the quality and financial goals set before them. Her work with smaller physician practices provided insight into the practical challenges that can arise as practices attempt to maintain compliance with new regulatory requirements.
Insights
- October 22, 2024
- ALERTS
On October 18, 2024, the New York State Department of Health issued guidance pausing implementation of Public Health Law §18-c, a new law that prohibits providers from obtaining a patient’s consent to pay for any health care service prior to the patient receiving the service.
- September 26, 2024
- ALERTS
NYS Public Health Law 18-c, a new law set to become effective on October 20, 2024, will prohibit providers from obtaining a patient’s consent to pay for any health care services prior to the patient receiving services.
- September 10, 2024
- ALERTS
The Federal Departments of Treasury, Labor, and Health and Human Services released final rules strengthening consumer protections for patients seeking mental health and substance use disorder treatments. Despite 15 years since the enactment of the Mental Health Parity and Addiction Equity Act (MHPAEA), barriers still exist, preventing individuals from receiving adequate coverage for these issues.
- April 17, 2024
- EVENTS
This Health Care Compliance webinar session will review HHS-OIG’s recently issued strategic plan for oversight of Medicare Managed Care and discuss the impact these initiatives could have on providers who participate in Medicare Advantage plans.
- February 15, 2024
- ALERTS
Despite the United States Supreme Court’s finding that the reduction of Medicare reimbursement rates for 340B outpatient drugs was unlawful, Medicare Advantage organizations (“MAOs”) maintain that they have no similar responsibility to make hospitals whole.
- November 16, 2023
- EVENTS
On January 1, 2022, the Federal No Surprises Act (NSA) went into effect to protect patients from surprise bills for out-of-network services but the law’s impact on physicians has been significant. Join us as we walk you through what you need to know about the NSA.
- August 22, 2023
- ALERTS
On August 14, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a request for applications for the Making Care Primary (MCP) Model, its newest innovation program aimed at improving patient care by supporting the delivery of advanced primary care services
- May 5, 2023
- ALERTS
The final budget for fiscal year 2023-2024 passed this week by the New York State legislature requires certain health care entities to pre-notify the Department of Health (the “Department”) of “material transactions” that meet certain financial thresholds.
- April 3, 2023
- ALERTS
On March 17, 2023, the Centers for Medicare and Medicaid Services (“CMS”) announced that independent dispute resolution (“IDR”) process called for in the Federal No Surprises Act should resume, and that the IDR entities could again make payment determinations in disputes between out-of-network providers and health plans that are subject to the NSA.
- February 15, 2023
- ALERTS
The New York State Executive Budget for fiscal year 2024 includes a proposed law to review and approve material transactions involving physician practices, Management Services Organizations (MSOs), and other health care entities.
- January 20, 2023
- PUBLICATIONS
The No Surprises Act requires providers and facilities to provide uninsured or self-pay individuals with a good faith estimate (“GFE”) of expected charges for a scheduled or requested item or service.