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Jessica D. Cottey
Jessica D. Cottey is Of Counsel to Gjerset & Lorenz, LLP. Dr. Cottey represents hospitals and health systems – including investor-owned companies, tax-exempt organizations, academic medical centers and publicly owned hospitals – on a wide variety of operational and transactional matters including licensing, compliance with federal and state healthcare regulations (including the Stark Law, the Anti-Kickback Statute), and governmental and private reimbursement issues. Healthcare providers rely on Dr. Cottey to represent and protect their business and legal interests in transactional matters as well as legislative and regulatory initiatives in the State of Texas. Dr. Cottey advises health systems, hospitals and physicians on the following:
- Quality Incentive Programs:
- Work collaboratively with state stakeholders to design state-specific Medicaid quality improvement programs.
- Work with the state Medicaid agency to submit programs to CMS for approval.
- Work with participants to implement approved programs, including:
- Identifying opportunities for improvement on select healthcare quality measures
- Designing a pathway to improve the selected quality measures
- Creating intermediate goals toward achieving improvement of quality outcomes
- Work with participants to complete audits of prior reporting.
- Medicaid certification and reimbursement:
- DSH: help many hospitals qualify for and receive their share of funding due under Disproportionate Share Hospital (DSH) program. Provide operational, financial, and legal guidance to help clients receive funding relative to which it is entitled.
- Supplemental Payment Funding Programs
- Texas’ Medicaid Section 1115 Waiver Program funding
- Uncompensated Care
- Delivery System Reform Incentive Payments
- Medicaid managed care reimbursement:
- Worked with State Medicaid agencies to obtain CMS approval of Medicaid managed care directed payment programs.
- Assist hospitals and physician groups in obtaining Medicaid managed care incentive payments for developing and implementing initiatives to improve access and quality of care to Medicaid managed care beneficiaries.
- Assist hospitals in obtaining enhanced payments from Medicaid managed care organizations for services provided to Medicaid managed care beneficiaries.
- Stark Law compliance, with an in-depth understanding of the Stark Law, its enforcement, and how to address alleged violations
- Anti-Kickback Law compliance, helping clients analyze arrangements for potential violations of the Anti-Kickback Law
- Assist State anti-kickback compliance
- Medical staff credentialing, peer review, and related matters
- Assist hospitals and health systems with contracting issues and disputes, helping them design and implement strategies to align their interests with physician practices
- Assist hospitals and physician practices with practice acquisitionsinvolvingsinglespecialtyandmulti-specialty practices and entire group practices
- negotiation of management and employment agreements, including non-compete and non-solicitation provisions
- asset purchase agreements
- promissory notes
- Lease and sublease issues arrangements
- Licensing and regulatory compliance matters
- Company structure and formation
- Regulatory compliance, including reimbursement, fee splitting, corporate practice and licensing
- Employee compensation and benefits
- Assist hospitals and physician practices with practice acquisitionsinvolvingsinglespecialtyandmulti-specialty practices and entire group practices
- Represent hospitals in alleged patient dumping violations (EMTALA) involving civil money penalties assessed by the Office of the Inspector General
- Assist provider organizations with their ongoing responsibility to comply with the patient information privacy requirements of The Health Insurance Portability and Accountability Act (HIPAA) and the disclosure requirements of The Health Information Technology for Economic and Clinical Health (HITECH) Act, as well as state-specific patient privacy laws
- Obtaining and maintaining tax-exempt status with the IRS and state tax authorities
- Advise healthcare providers regarding Texas’ prohibition on the corporate practice of medicine and the necessity for, and formation and maintenance of, certified health organizations through the Texas Medical Board
- Licensure requirements for the practice of medicine in Texas and other states
- Mergers, acquisitions and joint ventures, representing healthcare entities in connection with the structuring and development of joint ventures
Education
- University of Texas, J.D., with honors, 2004
- University of Texas Southwestern Medical Center at Dallas, M.D., 1998
- Baylor University, B.A., cum laude, 1994
Professional Affiliations
- Member, Health Law Section of the Austin Bar Association
- Member, Health Law Section of the State Bar of Texas
- Member, Health Law Section of the American Bar Association
- Member, Texas Young Lawyers Association
- Member, American Health Lawyers Association
- Member, Travis County Medical Society
- Member, Texas Medical Association