Erica Davila

Pre-Payment Reviews are all the rage with payors these days, and for those practices who think it's just another "request for records", they are usually in for a big surprise. Read more about them below and how to protect your practice.

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What a pleasure to join Carl White on the Practice Care podcast. I've often talked about the increasing regulatory pressure for transparency on businesses and healthcare bears an even higher burden. On the show, we discuss ways your healthcare practice can stay on top of -- and even ahead of -- these changes. Check it out! https://lnkd.in/gycNj_AF #privatepractice #healthcarelaw #employment #generalcounsel #equinoxlaw

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Excited to share my latest article with Boston Business Journal on why including an Embryo Clause in your prenuptial agreement is more important than ever. With the rise of assisted reproductive technology (ART), more couples are turning to IVF to start their families. However, many overlook the legal complexities that can arise if the relationship ends. In the article, I break down how an embryo clause can help protect both partners’ wishes and avoid future disputes. Check it out here: https://lnkd.in/e8pM9cUV #Prenup #IVF #FamilyPlanning #EmbryoClause #HelloPrenup #ReproductiveRights #PrenuptialAgreement #ART #ModernFamilies

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🎆 Columbia Law School: Adam Greenberg: GC to digital health superstars, think Ro & Warby Parker, shared his amazing experience as strategic advisor/legal counsel/business partner of high growth companies, the disruption of teleheath, practicing law in the most regulated industry in the US, federal law & policy - and fantastic career advice for my students🙏🏻 If you recall, when Warby Parker and Ro first came on the scene, the widespread reaction was “that will never work”. No one will ever order their glasses online and no guy is going to talk to someone they don’t know online about their ED and order Viagra. Just like Uber - no one will ever get in some stranger’s car that they ordered online- these were truly disruptive ideas! And not all disruptive ideas work and even the best ideas need a team to execute - Adam has been essential to at least two teams that changed the course of consumer health in the US. One of the goals of my course is to bridge the academic experience/learnings of a legal education with real world experience from friends & leaders in our industry - ✅ Warby Parker was valued at $6.8 billion when it went public in 2021. Ro has raised ~$1 billion & was valued at $6.6 billion (2022). Huge thank you to my students who were incredibly engaged and to Adam for impacting the next generation of health law lawyers. Wondering when your fund or company should engage an outside (fractional) GC or hire a GC, contact me and I’d be happy to discuss. I’m currently outside GC to innovative health companies and VC funds, serve on boards of directors & advisor boards, was Associate General Counsel of Ascension - one of the largest non profit health companies/ care delivery systems in the US, healthcare partner & lead of the Women’s Health & Wellness Practice Goodwin - and, over the years, time and time again, I’ve seen companies outperform competitors because they had great lawyers and legal strategies and others stumble and lose because they didn’t value the importance of strong legal counsel that understands your business, manages your risk and can be both legal and business advisor. Particularly in the healthcare industry, legal simply cannot be an afterthought, a rubber stamp once the plane has already taken off - it must be central to your strategy, plans and execution.

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I am pleased to share an alert co-authored with my colleague Moyo Koya analyzing the FTC's recent Final Rule that essentially bans non-compete covenants. The alert is the first of four. Alert #1 focuses on the Rule's impact on health care professionals. Alert #2 will focus on the Rule's impact on health care provider entities, with a concentration on nonprofit organizations. Alert #3 will focus on the the Rule's impact on changes of ownership of provider entities. Alert #4 will provide an update on lawsuits challenging the enforceability of the Rule. The analyses are designed to provide practical advice and takeaways. Stay tuned.

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Wanted to share our first corporate governance podcast of 2024! #ahla

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Listen Here: https://lnkd.in/gz5MCGPm Recorded live at the 11th Annual Becker's Healthcare CEO + CFO Roundtable, this episode features Sara Vaezy, Chief Strategy and Digital Officer at Providence. Here, she shares insights into her background & Providence, how healthcare providers are changing the consumer experience amid rising expectations, how her organization is looking at surveys as a way to collect & use patient data to better the patient experience, and more. This episode is brought to you by R1 RCM, a leading provider of technology-driven solutions that transform the financial performance of hospitals, health systems, and medical groups. R1 delivers proven, scalable operating models that power sustainable improvements to net patient revenue, while reducing operating costs. To learn how you can build a future-ready revenue cycle today, visit us at www.r1rcm.com/beckers (https://lnkd.in/grdk6GtT) For more information about Becker's Healthcare, please contact Jessica Cole or Scott Becker. #podcast #healthcare #womensleadership

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T.J. Ferrante, vice chair of Foley's Health Care Practice Group, is speaking during Spruce Health's upcoming webinar, "U.S. Federal and State Telehealth Law & Policy—2024 & Beyond," on June 12. This panel will examine the current regulatory landscape as it relates to digital health. Click below to learn more and register. #Webinar #Telehealth #HealthLaw

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Dull topic. Yet oddly thought-provoking.   The Wall Street Journal observes #CMS #transparency has had little impact on industry payments to physicians. It’s a fair observation about the numbers, even if the article’s characterization of the motivations seems a bit misguided.   Not big news.   But I always wonder whether the #ESG reporting folks are taking notes.   This decade-long #lifescience endeavor has generated an entire cottage industry. Careers have been dedicated to it. Experts have made untold sums setting up #compliance systems.   And the needle has moved. But... ❓Has the movement been on par with the cost? ❓When was the last time you checked the #OpenPayments website before choosing a doctor?    As companies now grapple with defining and reporting on #sustainability metrics, it’s easy for executives and consultants to swarm the shiny issues and then delegate implementation to people who get lost in the task. After a while, the whole thing gets relegated to a “basement department.”    But #climatechange seems infinitely more consequential.   Yes, measuring is important. But it’s only the first piece.  #OperationalImprovement is where the rubber meets the road.   So easy to say. So hard to do…

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Listen Here: https://lnkd.in/gq4t4dhe In this episode, Scott Becker and Alan Condon, Editor-in-Chief at Becker's Healthcare, explore the ongoing challenges facing nonprofit health systems, including high labor costs and inflation. They discuss why some systems are outperforming others and highlight key market expansions by both nonprofit and for-profit hospitals in high-growth regions. For more information about Becker's Healthcare, please contact Jessica Cole or Scott Becker. #podcast #healthcarenews #hospitalfinance

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For better or worse, healthcare is big business in the U.S., with healthcare spending accounting for over 17% of GDP. It’s no surprise, then, that private equity (PE) firms are investing in healthcare. PE firms are now investing hundreds of billions of dollars in healthcare each year, and are particularly active in areas like hospitals, physician practices, home healthcare, and nursing homes. Researchers, commentators, and government officials have expressed concerns that the increasing role of PE in healthcare may lead to prioritizing profits over patient outcomes and access to quality care. Policymakers have noted that PE backing often drives up both price and utilization, especially in high-margin specialties and services, resulting in higher overall costs. When PE firms cause their portfolio companies to engage in conduct that crosses the line from maximizing profits to defrauding government programs, the PE firm itself is exposed to False Claims Act liability. DOJ has made clear that PE firms can be held responsible for causing the submission of false claims when they veer into healthcare decision-making, including by directing business conduct and setting revenue targets. For more on the various spaces where you might PE money in healthcare, check out our page on Healthcare Fraud: https://lnkd.in/gnCw8Biq

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Delaware's favorable corporate laws have attracted founders, but recent decisions by the Chancery Court have disrupted established practices, causing uncertainty. On July 17, the Governor signed a bill amending corporate statutes to allow agreements that shift decision-making authority from the board to founders or major shareholders. Read more below. #Delaware #Founders #Shareholders

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Fractional Executives are in the news. Check out my blog post about Fractional In-House Counsel. https://lnkd.in/eUVt-w4u

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Medicare proposes to cover some digital therapies: "CMS proposes in its CY2025 physician fee schedule draft rule that three new codes, GBMT1-3, pay for the supply of a digital mental health treatment device and for physician time spent interacting with the patient regarding the device. The proposal would allow providers to receive reimbursement for the use of FDA-cleared devices that leverage software to provide behavioral health therapies." https://lnkd.in/gpQrJE5q

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Washington and Nevada consumer health privacy laws (with scoping originally tied to reproductive health data but expanded much broader) went into effect March 31 and OCR has just announced a Final Rule to further the #HIPAA Privacy Rule protections with regard to reproductive health data, prohibiting disclosure of PHI when sought to investigate or impose liability on individuals, health care providers, or others who seek, obtain, provide, or facilitate reproductive health care that is lawful under the circumstances in which such health care is provided, or to identify persons for such activities. #privacylaw

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Managing #hypertension through remote monitoring is the better care path forward. More data and regular touch points are superior to the in-clinic snapshot given to a physician.

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