Danielle Trostorff. Overview. Representative Matters. Shareholder

Transcription

1 DANIELLE TROSTORFF Shareholder is a shareholder in the Health Care Law Department of Baker, Donelson, Bearman, Caldwell & Berkowitz, P.C. and has practiced exclusively in health care and compliance since Overview Ms. Trostorff has experience handling health care regulatory matters, transactions, Medicare/Medicaid and third party reimbursement claims, and cost reporting appeals and audits (including RAC, ZPIC, RADV, OIG, CMS and other contract auditor reviews), contracts, acquisitions and mergers, government and government payor audits and investigations, enforcement actions and suspensions, False Claims Act and qui tam matters as well as EMTALA, HIPAA, E-health, survey, fast track termination, licensing and certification, CHOW, ACO, Value Based Purchasing, fraud and abuse and Stark law, voluntary disclosures, and other compliance issues. Ms. Trostorff represents all types of health care providers and suppliers, as well as pharmaceutical and Medicare Advantage Plans. She handles matters before the Provider Reimbursement Review Board and other administrative review bodies, CMS, the OIG, federal AUSAs, state Medicaid fraud units and federal courts. She is listed in Best Lawyers in America in health care since 1993, Louisiana Super Lawyers in health care since 2007 and the editions of Chambers USA. She was named Best Lawyers in America Lawyer of the Year in New Orleans in Health Care Law in Representative Matters Represented a hospital in Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) reporting and appeal. Assisted suppliers and providers in Recovery Audit Contractor (RAC), ZPIC and Medicaid audits including challenging extrapolation matters. Negotiated multi-provider acquisitions. Served as hearing officer in medical staff disputes. Advised suppliers on fraud and abuse anti-kickback statute and physician self referral (STARK) law compliance. Represented suppliers and providers in reimbursement, appeals and post pay audits. Represented a home health agency in a fraud exclusion before the Office of Inspector General. Represented a health maintenance organization in qui tam and governmental investigations alleging a pharmaceutical company switch program. 1

2 Represented a hospital in a civil and criminal false claim investigation regarding cardiac interventional procedures. Represented a hospital in a psychiatric and outpatient partial hospitalization program civil and criminal investigation. Represented a major hospital system in a pharmaceutical qui tam matter. Represented a major hospital system in a class action alleging indigent care. Represented a billing company in a civil and criminal government investigation of alleged false billing/false claims. Represented a billing company in a false claim qui tam action alleging improper billing and coding. Represented a nursing home in a civil and criminal false claim and quality of care investigation regarding wound care. Represented hospitals, physicians, infusion therapists, physical therapists, cardiac catheterization, independent diagnostic testing facilities (IDTFs) in post pay review audits. Represented a physician in physician self referral law (STARK law) voluntary self disclosure. Represented suppliers and providers in voluntary self disclosure. Represented suppliers and providers in implementing compliance programs, responding to civil investigative demands and negotiating corporate integrity agreements. Represented providers in national OIG initiatives. Professional Honors & Activities Listed in The Best Lawyers in America since 1993; Health Care Law Named the Best Lawyers' 2013 New Orleans Health Care Law "Lawyer of the Year" Named as a Leading Health Care Attorney by Legal Media Group (2006) Listed in Louisiana Super Lawyers in Health Care since 2007 Listed as a top Louisiana lawyer in Chambers USA in Healthcare ( ) Recognized as a "Pro Bono Champion" by the American Health Lawyers Association (AHLA) Recognized as a "Top Lawyer" by New Orleans Magazine (2010, 2013, 2015, 2017) American and Federal Bar Associations Texas Hospital Association American Academy of Hospital Attorneys/National Health Lawyers Association Tulane University Women's Association Women's White Collar Defense Association Chair, Louisiana Chapter The Chamber/New Orleans and the River Region (Medical Industry Council) 2

3 Board of Trustees Cornell University Council ( ) Recipient, Louisiana State Bar Association's Pro Bono Century Award (2016) Recipient, Baker Donelson's New Orleans Pro Bono Award Louisiana Society of Hospitals Attorneys of the Louisiana Hospital Association (President ; Past President ) Adjunct Professor, Tulane University, School of Public Health and Tropical Medicine ( ) Courses: Health Care Law, Regulatory Environment Greater New Orleans Women's Healthcare Executive Network (President 1995, ) New Orleans Bar Association (Health Care, Biotechnology & Medical Malpractice Committee, CoChair , Chair ) American College of Healthcare Executives (Regent's Advisory Council/Louisiana 1995) Cornell Alumni Admissions Ambassador Network (Chairperson, Louisiana) Women to Watch, Women & Co. New Orleans City Business (1993) Who's Who in the World, 21st Edition (2003 ) Who's Who in American Education, 6th Edition (2003 ) New Orleans CityBusiness Who's Who Annual Director (2000) Outstanding Young Women of America (1997) Who's Who in American Law, 8th Edition (1997) Five Hundred Leaders of Influence, 2nd Edition (1994) American Health Lawyers Association (AHLA) ACO Performance Measures and Accountability Subcommittee AHLA Fraud and Abuse Practice Group Member AHLA Healthcare Fraud and Compliance Interest Group Board of Directors, eq Health (2013 present) Agenda for Children Advisory Board President, Audubon Park Tennis Club ( ) Publications "Proposed Home Health Regulations Add a Number of Key Substantive Changes," Payment Matters (September 2018) "Recent Pharma Settlements Shed Light on Compliance Risks Associated with Donations to Patient Assistance Charities," AHLA Fraud and Abuse Bulletin (July 2018) "Dodd-Frank Whistleblower Protection Restricted By Supreme Court" (February 2018) 3

4 "Baker's Dozen 13 of the Best Places to Visit in the Big Easy," Women's Initiative Newsletter (December 2017) "Home Health Payment Rule Published," Payment Matters (November 2017) "Requirements for Participation Guidance for LTC Surveyors Published" (November 2017) "CMS Finalizes Revamped Home Health Agency Conditions of Participation," Payment Matters (January 2017) "HHS OIG Expands Safe Harbors, but Doubles Down with Enhanced Civil Monetary Penalties" (December 2016) "CMS Says: No More Arbitration Provisions in LTC Admission Agreements" (September 2016) "Health Care, Defense and Other Government Contractors Will Face False Claims Act on Implied False Certification Theory" (July 2016) "CMS Relaxes Proposals for Returning Overpayments, but Significant Questions Remain" (February 2016) "Baker Donelson Comments on CMS's Proposed Changes to the Stark Regulations" (September 2015) "Home and Community-Based Services: Seven Things You Need to Know" (July 2015) "Time to Revisit Your Physician Relationships" (July 21, 2015) "Nursing Home Reporting of Reasonable Suspicion of a Crime" (March 19, 2014) "Medicare and Medicaid Fundamentals," ABI Healthcare Insolvency Manual, Chapter 9 (2012) Co-author/Co-editor "Quality and Other Reporting Requirements," AHLA member briefing (September 2011) "Certification and Licensure," A Guide to Accountable Care Organizations, AHLA's The ACO Handbook, Chapter 10 (2011) Speaking Engagements "The 32nd Annual National Institute on White Collar Crime" (February 2018) "Nursing Home Failure of Care Litigation: Applying the New ACA Quality of Care Requirements to Your Care," NBI Teleconference (December 2015) "Evolving Payment Models," 26th Annual Health Law Symposium (November 2015) "HIPAA Compliance for ACOs, Clinically Integrated Networks and Other Health Care Reform Integration Models," 2015 AHIMA Convention & Exhibit (September 2015) "Preparing a RAC Appeals Strategy," Lorman Education Services Webinar (June 2014) "Managed Care Compliance: RAC, RADV, False Claims Act and OIG and CMS Initiatives," HCCA's 2014 Managed Care Compliance Conference, Scottsdale, Arizona (February 2014) "Health Law and Regulatory Update," American Medical Rehabilitation Provider Association Educational, Amelia Island, Florida (September 2013) 4

5 Panelist "Health Law and Regulatory Update," American Medical Rehabilitation Provider Association Meeting, New Orleans, Louisiana (June 2013) "Legal Perspective: Evaluating Risks and Taking Effective Action to Ensure Compliance," Medicare Advantage Compliance Summit, Miami, Florida (January 2013) "Common ASC Legal Issues: A Round Table Discussion," Texas Ambulatory Surgery Center Society Conference, Dallas, Texas (November 2012) "How to Make Your Corporate Compliance Program Top Notch," Baker Donelson's Long Term Care Symposium, Nashville, Tennessee (November 2012) "Top Nursing Home Liability Claims in Louisiana," National Business Institute, New Orleans, Louisiana (August 2012) "New Government Focuses on Fraud and Abuse Enforcement," NCVH 13th Annual Conference, New Orleans, Louisiana (June 2012) "Lunch with Experience," ABA Law Student Division, 13th Circuit Spring Meeting, Loyola University, New Orleans, Louisiana (March 2012) "Master Class on Pro-Active Audit Preparation Strategies and Tools for CMS, RAC, ZPIC and Other Applicable Audits for Medicare Advantage and Part D Plans," American Conference Institute, Philadelphia, Pennsylvania (January 2012) "Developing Compliant Marketing Guidelines that Meet CMS Muster," American Conference Institute, Philadelphia, Pennsylvania (January 2012) "Preparing a RAC Appeals Strategy," Lorman Education Services Teleconference (January 2012) Seminar Chair "Healthcare Reform 2011," Louisiana State Bar Association, New Orleans, Louisiana (October 2011) "Navigating the Waters of the Medicare Secondary Payer Act," New Orleans Bar Association (August 2011) "A New Era for 'Quality': Moving Beyond Clinical Outcomes," Physician-Legal Issues Conference, ABA Health Law Section, Chicago, Illinois (June 2011) "Commercial Payers and Provider Accountability," Baker Donelson's Accountable Care Symposium, Nashville, Tennessee (June 2011) "Healthcare Reform and Quality of Care," sponsored by the Louisiana State Medical Society (May 2011) "Accountable Care Organizations: The Cost of Performance It's Not Your Mother's Fee for Service World," AHLA Hospitals and Health Systems Law Institute, Las Vegas (February 2011) Webinars Long Term Care Disaster Readiness: How Your Facility Can Prepare, Respond, and Recover (November 2017) 5

6 Value Based Purchasing and Other ACA Initiatives What It Means to Your Nursing Facility (July 2016) Education Washington University, J.D., 1977 Washington University, M.S.W., 1976 Cornell University, B.S., 1973 Admissions Louisiana, 1981 Texas, 1993 New York, 1978 District of Columbia, 1978 U.S. Supreme Court, 1994 The Supreme Court of Texas, 1993 U. S. District Court for the Middle and Western Districts of Louisiana, 1983 U. S. District Court for the Eastern District of Louisiana, 1981 Louisiana Supreme Court, 1981 U.S. Court of Appeals for the Fifth and Eleventh Circuits, 1981 U.S. Court of Appeals for the District of Columbia, 1980 U.S. District Court for the District of Columbia, 1979 District of Columbia Court of Appeals, 1978 New York State Court of Appeals, 1978 is 'an excellent healthcare lawyer,' according to market commentators. She regularly advises on regulatory compliance and transactions involving healthcare organizations, as well as advising on reimbursement claims. FROM CHAMBERS USA