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ATTORNEY

Location:
Fort Lauderdale, FL
Posted:
June 07, 2018

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Resume:

EXECUTIVE SUMMARY:

Experienced corporate generalist with substantial law firm and in-house experience representing all aspects of commercial operations. Particular experience in the areas of complex transactions; contracting; M&A; joint ventures and management services agreements; claims and risk management; real property; employment; compliance programs; corporate governance; and, commercial litigation.

EXPERIENCE

Partner

Law Offices of Julie Allison, P.A.

Hollywood, Florida

December 2017 - Present

In association with David J. Armstrong Law, LLC. A growing full-service law firm with a national clientele of clients including entrepreneurs, hospitals, clinics, facilities, clinical laboratories, physicians, medical groups, insurance brokers and healthcare provider networks.

Focus on complex commercial transactions; purchase and sale of operations; joint ventures and M&A; federal programs and commercial payor contracting; reimbursement disputes; Stark/AKS compliance; ERISA; HIPAA; licensure and regulatory matters; commercial litigation; and legislative lobbying.

Recent examples include:

oResponsible for tort and professional liability litigation for a south Florida hospital and one of Florida’s largest substance abuse treatment facilities.

oRecently closed the sale/lease-back of a residential treatment facility for a south Florida client.

oCurrently negotiating a joint venture exclusively licensed for the sales, distribution and provider network development of clinic-based services with a national provider of interventional orthopedic stem cell technology.

oCurrently negotiating a clinical laboratory joint venture for a Florida client with a Georgia based provider.

oRepresent an online provider of discounted cosmetic procedures. Secured IP and support development of online delivery platform including HIPAA privacy and security and online “click-through” provider participation and customer agreements.

oRecently closed a $5 million asset based revolving credit facility for a healthcare client.

oServe as outside general counsel for a college of medicine offering doctoral and master’s degree programs in pharmacy and biomedical sciences.

In-House General Counsel, Chief Compliance Officer & Corporate Secretary

Promise Healthcare, Inc. Boca Raton, Florida

May 2008 – December 2017

Promise Healthcare, Inc. is a privately held healthcare company engaged in the delivery of post-acute care via a multi-state system of more than 20 long term acute care hospitals and two skilled nursing facilities in nine states.

Reported to the chief executive officer. Responsible for advising business teams on legal risks, interpretation of contracts, business strategy related to national transactions and operations; developed and managed the risk and compliance programs, conducted all internal investigations and

provided regular risk and compliance reporting to the board of directors; established and enforced all policies and procedures and company code of conduct; drove business deals to completion by negotiating and drafting all legal and business terms and closing transactions consistent with the goals of the chief executive officer and board of directors; managed legal department budget including claims and litigation management and outside counsel spend.

Select accomplishments include:

oLed company through an SEC investigation, federal court litigation and a

$550 million change of ownership that closed in March 2014.

oClosed a $50 million line of credit in 2014 and later refinanced with a $75 million Wells Fargo line of credit in 2016.

oFacilitated expansion of operations from fourteen to twenty-seven hospitals; purchasing eight, building four on purchased real property and subsequently selling three and merging two. The hospital merger required implementation of a bankruptcy avoidance workout of $14 million in trade payables at 13.9 cents-on-the-dollar – saving over $12 million.

oNegotiated entry of company into a large regional Accountable Care Organization designed to ensure delivery of high quality care to Medicare patients and which resulted in driving predictable revenue to company facilities.

oClosed multiple hospital asset purchase and sale agreements, real property acquisitions via purchase and lease and built three hospitals from the ground up through licensure

oFormed and opened several new lines of business including a workers’ compensation clinic, an outpatient wound care program, a clinic-based wellness business, and an inpatient and outpatient substance abuse program.

oEstablished a contracts management system to review and approve all corporate and facility contracts with a value in excess of $5,000.

oImplemented an internal workers compensation program that reduced employee claims experience by 20%.

oFormed a SaaS technology joint venture to implement and sell cloud-based EMR technology.

oFormed and managed the corporate governance for over 60 affiliated and subsidiary legal entities.

Created and implemented the following programs for the company:

oEnterprise risk management program.

oCompliance program including company code of conduct, compliance hotline, formed and chaired the corporate compliance committee.

oInternal grievance and appeal process for employee complaints to reduce employment litigation.

oElectronic contracts and P&P management and tracking system.

oNational policies and procedures committee.

oElectronic corporate governance database management system.

oElectronic matter management and outside counsel billing management system including integrated outside counsel billing guidelines.

oInternal audit committee.

Senior Counsel Mid-Atlantic States

Kaiser Permanente

Rockville, Maryland March 2006 – April 2008

Kaiser Permanente (“Kaiser”), at the time, was the largest non-profit integrated health care delivery system in the United States serving over 8.5 million members with $25 billion in annual revenue and over 145,000 employees including 12,000 employed physicians.

Provided general corporate counsel services for Kaiser’s Mid- Atlantic and Southeastern United States regions including three licensed HMO’s and an integrated healthcare delivery system consisting of ten hospitals and medical centers with over 2,500 employed physicians providing primary, specialty, diagnostic and emergency care to over 1.2 million members.

Supported operations in each region with an emphasis on health plan operations, transactional, regulatory, and compliance issues confronting an integrated delivery system including:

o Litigation and risk management; corporate governance; oversight of regulatory affairs; compliance program design and implementation; legislative analysis; commercial and federal programs; provider participation contracting and network management (including IPA’s, PHO’s and PPO’s); individual and employer group contracting (self-funded and fully insured employer sponsored plans); clinical research programs; administrative proceedings; sales, marketing and underwriting support; state and federal privacy compliance; community benefit and charitable programs administration; and, support of health care provider operations including medical staff issues, quality/professional licensure investigations; scope of practice; credentialing; peer review; and, coding, billing and reimbursement.

Additional responsibilities included:

oSupport of provider network development and maintenance; new product development and market strategy (including major acquisitions and service area expansion initiatives).

oServed as Compliance Counsel, Kaiser National Compliance Office (“NCO”) with responsibility for the oversight and implementation of the corporate compliance program.

oLegal advisor for the National Fraud and Abuse Special Investigative Unit (“NSIU”). Special emphasis on Fraud and Abuse compliance, investigation and recovery including Anti-Kickback, Stark Law, and the False Claims Act.

Partner

Law Offices of Steven M. Ziegler, P.A. Hollywood, Florida

November 2000 - March 2006

Partner in a twenty-attorney law firm specializing in the representation of all aspects of commercial

operations for Managed Care Organizations (“MCO’s”). Managed a health care practice group of attorneys and paralegals with a primary focus on complex litigation, regulatory compliance including compliance programs, Stark and AKS compliance, administrative proceedings and risk management.

Special emphasis on:

oHealthcare transactions; provider participation contracting and network management (including IPA’s, PHO’s and PPO’s).

oDevelopment, implementation, and support of corporate compliance programs; including, counseling fraud and abuse and regulatory affairs issues.

oSales and marketing compliance for commercial and federal lines of business.

oComplex commercial health care litigation, including ERISA, bad faith, and class actions.

oRepresentative clients included: Humana, Inc.; BlueCross BlueShield of Florida; Aetna Inc.; Well Care Health Plans, Inc.; CIGNA; UnitedHealthcare; Total Health Choice; VISTA Health plan, Inc.; Neighborhood Health Partnership, Inc.; and, AvMed Inc.

Assistant General Counsel

BlueCross and BlueShield of Michigan Detroit, Michigan

May 1995 - November 2000

Assistant General Counsel for BlueCross BlueShield of Michigan (“BCBSM”), which ranked first at the time among all Blue Cross Plans nationally with over $6 billion in annual revenue and second in membership with over four million members.

Responsibilities for commercial and federal programs (e.g. Medicare, FEHBP) included:

oState, federal and administrative litigation for BCBSM, its wholly owned HMO subsidiary, and self-funded ASO employer sponsored plans (e.g. General Motors, Daimler-Chrysler, Ford Motor Co., Kmart).

oCounsel related to provider network management including: provider contracting, credentialing, and peer review, as well as termination, administrative appeals and litigation.

oCounsel for Fraud and Abuse; Compliance and regulatory affairs; rate and product filings; and, associated actions before the Department of Insurance.

oCounsel for the SIU fraud and abuse department including civil and criminal healthcare provider audit and fraud investigation and recovery.

oResponsible for development, implementation and ongoing training on the BCBSM Corporate Code of Business Conduct.

oLegal representative of the provider contract termination appeals committee.

Associate Attorney

Kitch, Saurbier, Drutchas, Wagner & Kenney, P.C.

Detroit, Michigan

August 1992 - May 1995

Associate attorney for a one hundred plus attorney law firm specializing in the defense of professional and hospital liability and personal injury cases. Clients included all major metropolitan Detroit area self-insured hospital organizations, professional liability carriers, individual physicians and practice groups, and a national retail chain (Target stores).

Conducted risk management "in-service" education and training of physicians and hospital personnel on the avoidance of professional liability.

Tried several cases to verdict including successful jury trial defense of a medical malpractice case brought by a professional baseball pitcher (Detroit Tigers) against the Henry Ford Health System.

EDUCATION

The University of Michigan Law School Michigan State University

Ann Arbor, Michigan East Lansing, Michigan

Juris Doctor, cum laude B.A., Communications

BAR ADMISSIONS:

Florida, Maryland, Pennsylvania and Michigan

PERSONAL:

Married with a teenage daughter.

Live at the beach and enjoy boating, fishing, snorkeling, scuba diving and all water sports.

Founder of the Beautiful Life Foundation, Inc. (an IRS 501(c)(3), Florida Not for Profit Corporation) a startup non-profit addiction recovery organization that engages victims of substance abuse in fundraising activities to improve their confidence and self-esteem, teach life and job skills, and elevate public awareness while enabling them to become an active participant in their own recovery.



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