- Representing hospitals, health systems, physician groups, and other health care providers in operational and regulatory matters (e.g., Medicare and Medicaid reimbursement, 340B compliance, mental health, fraud and abuse, compliance program requirements, and privacy issues).
- Representing and advising hospitals and health systems in acquisitions and obtaining state attorney general approvals.
- Advised Navicent Health on its member substitution with Atrium Health Inc. and obtained state attorney general approval for the transaction.
- Advised Navicent Health on the lease of Peach Regional Medical Center and obtained state attorney general approval for the transaction.
- Counseling private equity firms and other health care industry clients in the analysis of health care regulatory issues (e.g., corporate practice of medicine, fee splitting, change of ownership) related to strategic joint ventures and other complex transactions.
- Representing clinical research sponsors, sites, physician-investigators, and contract research organizations in drafting and negotiating clinical trial agreements.
- Served as regulatory counsel for Horizon Blue Cross Blue Shield of New Jersey, providing advice on ACA market reforms, state health insurance and managed care laws, state and federal mandated benefits, state and federal privacy laws (e.g., HIPAA/HITECH, SAMHSA Part 2), ERISA Form 5500 reporting, out-of-network reimbursement, coordination of benefits, wellness programs, prompt pay requirements, Mental Health Parity and Addiction Equity Act (MHPAEA) requirements, utilization management, and other regulatory issues.
- Served as regulatory counsel for a nonprofit startup health insurer in New York, providing guidance on federal and state laws related to ACA individual and small group plans offered by a state-based health insurance exchange/marketplace.
- Representing health care providers on Medicare and Medicaid reimbursement issues involving graduate medical education (GME) payments, Medicaid supplemental payments such as disproportionate share hospital (DSH) payments and upper payment limit (UPL) payments, and alternative payment models.
Counsel,
- Phone: 404.881.4401
- Email: esther.yu@alston.com
Esther brings clients a set of unique perspectives with her experience in both the insurer and provider spaces as former in-house counsel at one of the largest health insurers in the U.S. and in representing hospitals and health systems in private practice.