We are proud to announce that Jeffrey Brown has been recognized on the 2022 list of New Jersey Super Lawyers and Julia Belton has been recognized as a 2022 New Jersey Rising Star.

Super Lawyers, a Thomson Reuters business, recognizes attorneys who exhibit excellence in the practice of law. The selection process is multi-phased and includes independent research, peer nominations, and evaluations that identify a high degree of peer recognition and professional achievement. Being named a Super Lawyer is a tremendous honor reserved for only the top 5% of all lawyers in a given state or region.

 

As many of you may already know, effective January 1, 2022, the New York State Health Insurance Plan (“NYSHIP” or the “Empire Plan”), acting through its administrator UnitedHealthcare, Inc. (“United”), dramatically and improperly reduced the rate at which the Empire Plan reimburses out-of-network physician services.  United is wrongfully slashing those rates – generally from 80% of usual and customary charges to a rate about 15% of what is otherwise required – under the guise that it has authority to do so under the federal No Surprises Act.  The impact of these unilateral and unlawful actions will be staggering on the reimbursement rates for out-of-network providers and will also, as a consequence, have a devastating impact on the availability of out-of-network providers to care for United’s members.

Consistent with its decades-long history and mission of serving the healthcare industry, Garfunkel Wild P.C. (“GW”) immediately stepped into the fray to challenge the actions of United.  Recognizing that the resolution of this dispute may involve a political process, and with the endorsement of the Medical Society of the State of New York (“MSSNY”) that represents over 20,000 New York State licensed physicians, GW wrote to Governor Hochul to encourage her to take steps to compel United to comply with the existing terms of reimbursement that were negotiated and agreed to by NYSHIP’s unions.  Click here to view the letter.  MSSNY, which has also been active in challenging United, likewise sent a letter on behalf of its members. Click here to view the letter. We are informed that discussions are currently taking place between the Governor’s Office and the unions concerning these and related issues.

While that process plays out, GW will use the time to craft a legal challenge to United’s actions should such a legal challenge prove necessary. While some may be anxious to bring immediate legal action, GW believes that such immediate action may not be the best path for a positive outcome.  Particularly given that the New York State government, including the Governor’s office, is in the midst of budget negotiations, GW believes that the parties need to let this process ripen without the potentially counterproductive pressure of an immediate lawsuit.  Indeed, starting a lawsuit so quickly after sending a letter designed to inform the political process could be seen as bad faith.  Moreover, any immediate legal challenge may be rendered moot by the outcome of that process.  Further supporting of the notion of proceeding smartly and cautiously is the reality that an immediate lawsuit will not provide an overnight remedy to United’s wrongful actions, but will likely take years.

Consequently, GW, with the endorsement of MSSNY, is striking a different course, one that is aggressive, yet sensible, calculated and cost-effective.  GW will use this brief interlude to develop a comprehensive and sustainable legal challenge to United’s action in order to enhance the litigation’s chances of success, should litigation prove necessary.  Toward that end, GW has been forming a coalition of providers and other stakeholders who are interested in joining this effort, a coalition that has been increasing steadily in size with each passing day.

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If you are interested in joining this coalition, please contact the Garfunkel Wild attorney with whom you regularly work, or any member of the GW/United Committee: Andrew Blustein at ablustein@garfunkelwild.com; Debra Silverman at dsilverman@garfunkelwild.com; John Martin at jmartin@garfunkelwild.com or Andrew Zwerling at azwerling@garfunkelwild.com.  We will then forward you the necessary logistical information to join.

Click Here to download the Legal Alert.

 

Thursday, March 10, 2022 | 12:00 pm – 1:00 pm (EST)

Speakers:   Andrew Zwerling and Lauren Levine

Garfunkel Wild’s Andrew Zwerling and Lauren Levine will present the webinar “No One Showed At The Office Today: Challenges and Best Practices for Employers Confronting a Remote Workforce″ on March 10, 2022.

With the COVID-19 pandemic, working from home or telecommuting has become even more commonplace. Knowledge of how to respond to common issues employers encounter with remote employees and best practices for addressing these is critical in the effort to minimize litigation risk and avoid other potential harm to employers. This webinar will address how employers can handle challenges such as:

  • Wage and hour compliance under the Fair Labor Standards Act.
  • Questions on whether telecommuting qualifies as a reasonable accommodation under the Americans with Disabilities Act.
  • Subjecting the employer to the tax laws of the jurisdictions.
  • Potential discrimination claims.
  • General challenges associated with remotely managing employee performance.

Click here to view.

 

4th Annual CHEMED Medicine & Ethics Conference

February 17-20, 2022
Woodcliff Lake, New Jersey

Speaker: Jeff Adest

Garfunkel Wild is sponsoring and Partner/Director Jeff Adest will present at the 4th Annual CHEMED Medicine & Ethics Conference, February 17-20, 2022.  Mr. Adest will present on “Developing Services Delivery and Technology Considerations” and “Emerging Employee Issues: Vaccines, Marijuana and Related Concerns.”

Click Here to learn more.

 

 

Garfunkel Wild Partner Stacey L. Gulick has been named a 2022 “Client Service All-Star” in BTI Consulting Group’s survey of general counsel from the world’s largest corporations. The annual list is “the gold standard” used to identify attorneys delivering “the absolute best client service.”

BTI compiled the 2022 list by conducting in-depth interviews with more than 350 top legal decision-makers at large organizations with $700 million or more in revenue. Only 565 attorneys across the country received this distinction. The awards are independently sponsored and conducted by BTI Consulting Group.

Stacey L. Gulick is Chair of the Garfunkel Wild’s HIPAA Compliance Practice Group. With over 30 years of experience, her practice focuses on Federal and state regulatory, interoperability and technology related issues, including response to government inquiries, compliance initiatives and transactions. In particular, Ms. Gulick assists clients in implementation of cybersecurity and HIPAA compliance programs and investigations, information security breach response, medical staff hearings and bylaws, and healthcare diligence in large transactions such as mergers and acquisitions. Ms. Gulick also has extensive experience in the unique regulatory and business needs of hospitals, clinical laboratories, DSRIP performing provider systems, ambulatory surgery centers and federally qualified health care centers.

Click here to learn more about the 2022 BTI “Client Service All-Stars”.