Myla R. Reizen

Partner

Overview

Myla Reizen is a partner and health care lawyer with Foley & Lardner LLP. She focuses her practice on serving clients in the health care industry, particularly with respect to government investigations, health care regulatory matters, internal investigations, and compliance. Ms. Reizen is a member of the firm’s Health Care Industry Team and the Government Enforcement Defense & Investigations Practice.

Ms. Reizen has significant experience handling health care government investigations and qui tam cases covering a wide range of areas such as physician arrangements, quality of care issues, and coding and billing matters. In this regard, Ms. Reizen has negotiated settlements with numerous government entities, such as the U.S. Department of Justice and the Office of Inspector General. She has also conducted a substantial number of internal investigations and developed, implemented, and evaluated compliance programs for a wide spectrum of health care providers, including conducting internal reviews, providing comprehensive training and preparing policies and procedures. Ms. Reizen has also advised clients (including hospitals, physicians, skilled nursing facilities and home health agencies) undergoing various audits and reviews, including ZPIC, RAC and other Medicare and Medicaid audits as well as pre-payment reviews.

In addition, Ms. Reizen has represented health care providers with respect to complicated regulatory matters and a variety of operational issues. Over the past several years, Ms. Reizen has spent a significant amount of time on various initiatives, such as bundled payments, readmissions, value-based purchasing, quality standards, and care transition between acute and post-acute providers.

Ms. Reizen primarily represents health care providers, such as health systems, hospitals, home health agencies, skilled nursing facilities, hospices, and other health care entities. Her experience ranges from representing not-for-profit and government entities to for-profit systems. She has extensive practical in-house experience, as she was deputy chief compliance officer and legal counsel for a national dialysis company, and she also served as assistant general counsel for a national hospital company.

Representative Matters

INTERNAL AND GOVERNMENT INVESTIGATIONS 

  • Conduct significant number of internal investigations on wide variety for health systems, including critical care, short stay admissions, necessity of therapy services, research billing, oncology billing, outliers, patient steering, drug diversions, necessity of procedures (cardiac, neurology and GI) and physician arrangements 
  • Evaluate and prepare self-disclosures, including Stark, OIG and state 
  • Advise board of directors concerning investigations and self-disclosures 
  • Settle cases for large health systems for alleged unnecessary procedures 
  • Settle Medicare and Medicaid case for oncology billing for health system 
  • Settle cases for health systems for short stay admissions 
  • Settle cases for health systems for DRG coding 
  • Settle cases for transfer/discharge 
  • Settle cases for physician arrangements

AUDITS/REVIEWS

  • Respond to OIG Compliance Review 
  • Respond to numerous ZPICs in areas of therapy in SNF, oncology billing and home health visits 
  • Respond to RACs for range of providers

COMPLIANCE

  • Evaluate effectiveness of compliance programs 
  • Conduct physician arrangement reviews for a number of health systems 
  • Develop and/or revise policies and procedures for university and health systems, on topics such as billing, payments, physician arrangements, and potential referral sources 
  • Develop audit protocol 
  • Provide half-day compliance training to Hospital executives, Legal and Compliance on physician arrangements and potential referral sources 
  • Provide half-day compliance training to large hospital system on short-stay admissions 
  • Provide compliance training to board of directors

REGULATORY ADVICE

  • Provide regulatory advice for transaction involving acquisition of national IDTF centers 
  • Provide regulatory advice for Demonstrations and Waiver Projects 
  • Provide regulatory advice to home health and hospital arrangements 
  • Provide regulatory advice on numerous topics, including readmissions, quality of care, value-based purchasing, and coding and billing issues

Education

Ms. Reizen is a graduate of the University of Pennsylvania Law School (J.D.). She received her undergraduate degree from Vanderbilt University (B.S., summa cum laude).

Affiliations and Admissions

Ms. Reizen is a frequent presenter in national and state venues on compliance and legal issues. She has also been published in a number of national and state publications. She is on the executive council for the Florida Bar Health Law Section and is a member of the CLE Committee for the Florida Bar. Ms. Reizen is also a member of the American Health Lawyers Association, American Bar Association, and the Health Care Compliance Association.

Ms. Reizen is admitted to practice in Florida.

Publications

  • “Florida’s False Claims Act – Did You Know It Changed Last Year,” Health Care Law Today, March 10, 2014
  • “Should Readmissions Be On A Compliance Officer’s Radar?” Compliance Today, Health Care Compliance Association, August 2013
  • “OIG Work Plan Fiscal Year 2013 - What's New And What's Still On The Radar?” The Florida Bar Health Law Section Newsletter, March 2013
  • “Could Your Organization Be Subject To A Zone Property Integrity Contractors Audit?” The Advisory Board Law Review, November 30, 2012
  • “Legal Checklist For Acute-Post-Acute Affiliation Agreements,” The Advisory Board, July 2012
  • “Overpayment Rule Proposed,” The Florida Bar Health Law Section Newsletter, July 2012
  • “Readmissions And Continuum Of Care: What Is The Role Of Compliance?” Compliance Today, Health Care Compliance Association, July 2012
  • “The Law Review: Readmissions And Continuum Of Care,” The Daily Briefing, December 13, 2011
  • “RAC Update: Further Changes And Expansions On The Horizon,” Louisiana Ledger, April 18, 2011
  • “What's New In Health Care 2010,” Special Supplement to the Greater Baton Rouge Business Report, November 2010
  • “Quality Of Care: A Key Area In OIG’s Draft Supplemental Compliance Program Guidance for Nursing Facilities,” The Florida Bar Health Law Section Newsletter, December 2008
  • “Quality Of Care In Compliance Cases,” Compliance Today, Health Care Compliance Association, April 2008

Presentations

  • “Provider’s Response to the New Frontier of Medicaid,” Las Vegas, Nevada, February 2, 2015
  • “Post-Acute Compliance: Regulatory and Compliance Issues in Hospice and Home Health Industries,” Nashville, Tennessee, November 21, 2014
  • “Stark, Kickback and Florida Specific Provisions,” Florida Bar Association’s Health Care Regulatory Compliance Seminar, November 7, 2014
  • “Top 10 Regulatory Questions Facing Home Care Providers,” Orlando, Florida, July 24, 2014
  • “The Effective Role Of A Consultant,” Daytona Beach, Florida, June 18, 2014
  • “Telemedicine Legal And Regulatory Considerations,” Baltimore, Maryland, May 18, 2014
  • “Compliance-Quality, What Is the Overlap,” Jacksonville, Florida, January 29, 2014
  • “Florida Audits, Investigations, And Settlements,” Orlando, Florida, November 1, 2013
  • “Clinical Appropriateness Implications For Compliance Across The Continuum Of Care: Improving Quality And Avoiding Readmissions,” Philadelphia, Pennsylvania, October 15, 2013
  • “Clinical Appropriateness: Implications For Compliance Across The Continuum of Care: Improving Quality And Avoiding Readmissions,” Baltimore, Maryland, September 29 – October 1, 2013
  • “What Is The Connection With Quality And Compliance?” Daytona Beach Florida, June 2013
  • “Readmissions Legal & Compliance Issues From A Home Health Perspective,” Webinar, April 9, 2013
  • “Recent Health Care Trends From A Legal And Compliance Perspective,” Hallandale Beach, Florida, March 15, 2013
  • “What Compliance Officers Need To Know About Hospital Readmissions,” Baltimore, Maryland, October 1 – 2, 2012
  • “Legal Perspectives On Acute/Post Acute Affiliation Agreements,” Webinar, June 5, 2012
  • “CMS Proposed Overpayment Rule - Where Do We Go From Here?” Orlando, Florida, May 2012
  • “Quality Of Care: A Compliance Concern,” Orlando, Florida, January 18, 2012
  • “Recent Health Care Trends From A Legal And Compliance Perspective,” Hollywood, Florida, November 17, 2011
  • “Bundled Payments Initiative, Readmissions & Continuum Care—Implications For Acute And Post-Acute Providers,” Webinar, October 25, 2011
  • “Recent Health Care Trends From A Legal And Compliance Perspective,” Birmingham, Alabama, October 4, 2011
  • “Stark And Anti-Kickback Overview,” Miami Lakes, Florida, September 16, 2011
  • “The Medicare Shared Savings Program: Implications For Post-Acute Care,” Webinar, June 16, 2011
  • “Health Care Legislation Update—Accountable Care Organizations, Medical Home, And Other Key Trends,” Hollywood, Florida, May 26, 2011
  • “Unnecessary Readmissions—Legal Implications & Prevention Measures,” Webinar, April 5, 2011
  • “Health Care Fraud & Compliance: Updates, Trends, And Where To Go From Here,” Ft. Lauderdale, Florida, November 10, 2010
  • “Health Care Fraud & Compliance: Updates, Trends, And Where To Go From Here,” Baton Rouge, Louisiana, September 14, 2010
  • “RAC/CERT/Government Data Mining & Billable Compliance,” Webinar, August 26, 2010
  • “Key Issues And Updates From The Health Care Reform Legislation,” Webinar, August 5, 2010
  • “FUNdamentals Of Florida Healthcare Law,” Orlando, Florida, September 18, 2009
  • “Key Legal Topics For Home Health Agencies,” Orlando, Florida, June 20, 2008
  • “The Melding Of Quality Of Care And Compliance Issues,” Miami, Florida, May 22, 2008