Managed Health Care Industry Services
Effective representation of today's managed health care industry requires an array of legal skills delivered in a cost-conscious fashion, coupled with a thorough knowledge of the industry and an excellent grasp of the ever-changing regulatory environment.
Lawyers at Taggart Morton have represented participants in all facets of the health care industry -- health maintenance organizations, managed care insurers, self-insured employer sponsored benefit plans, third party plan administrators, hospitals, nursing homes, single-specialty and multi-specialty physician practices, health care consultants and management service organizations, inventors of medical devices, manufacturers of medical devices, distributors of medical devices, suppliers of durable medical equipment and medical supplies, home health care agencies, medical billing and collection companies, and provider networks. Projects for these clients have required the business, tax, antitrust, litigation, labor and employment law, technology and qualified plan expertise of firm lawyers as well as the expertise of firm lawyers necessary to daily work in the managed health care environment.
The members of Taggart Morton's Health Group participate in numerous industry professional organizations and frequently offer presentations to industry groups, yet manage to set aside time to keep abreast of new legal developments. With this diversified legal experience and substantial knowledge of the industry, Taggart Morton's Health Group is uniquely positioned to meet the legal needs of its clientele. Biographies of Taggart Morton Health Group lawyers and some examples of the Group's experience in various segments of the industry follow.
Managed Care Industry Practice
| Accreditation | Member Services |
| Antitrust & Trade Regulation | Medical Claims & Provider Billing |
| Arbitration & Mediation | Medicare & Medicaid |
| ERISA, COBRA & HIPAA | Medicare+Choice |
| False Claims Act | OIG Compliance |
| Stark, Fraud and Abuse | Provider Contracting & Credentialing |
| Health Care Collections | Subrogation & Third Party Recovery |
| Litigation - all state and federal courts | Utilization Review / Medical Necessity |
| Mergers and Acquisitions | Medicaid Managed Care |
| Form A, B, C and D Filing | IPA Formation |
| Corporate Governance | Medicare Secondary Payer |
Practitioners:
Perry Staub chairs both the Litigation and Managed Health Care - Litigation Practice Groups at Taggart Morton. Mr. Staub has been involved in the representation of health care entities, including managed care entities, for over twenty years. Perry specializes in health and managed care litigation, including: ERISA, provider contracting, employment and labor law, antitrust & trade regulation, False Claims Act, intellectual property, technology, subrogation and third party reimbursement actions, Medicare, and all manner of business and complex litigation disputes. In addition to his practice in various state and federal courts nationwide, Perry has been involved in cases and regulatory proceedings before the Department of Justice, the Federal Trade Commission, the Department of Labor, the Health Care Financing Administration (now CMS), the Louisiana Department of Insurance and the Louisiana Department of Labor. Perry lectures extensively on issues of interest in the health care industry, as well as on the developing use of technology in both legal and business contexts.
Mr. Staub's interest in technology has led to his involvement in the negotiation and preparation of medical technology licensing agreements; acquisitions and divestitures of medical technology; joint venture and "partnering" arrangements between developers of medical technology and manufacturers and distributors; encryption issues; counseling on online provision of medical services and on application of HIPAA's Medical Privacy and Transaction Standards.
Mr. Staub presently serves on the Board of Directors of the New Orleans Bar Association, where he also chairs the Technology Committee. He is a member of the American Health Lawyers Association, the Managed Care Interest Group of the AHLA; the Technology Practice Group of the AHLA; the American Bar Association (Sections on Health Law, Antitrust & Trade Regulation, Litigation, Science & Technology, Employment & Labor (ERISA), and Tort & Insurance Practice); the Health Care Compliance Association; the Louisiana State Bar Association's Health Law Section.
A.J. Herbert III chairs the Insurance Regulatory Services, Managed Health Care Industry Services – Transactional and Regulatory, and Corporate Law practice groups at Taggart Morton, L.L.C. Mr. Herbert has been involved in the representation of insurers, financial institutions, and health care industry stakeholders for over 20 years, in both Louisiana and Texas. He is experienced in a wide variety of the issues affecting these industries, including formations; dissolutions; mergers and acquisitions; the regulatory approval processes for all facets of company licensing; Form A-D filings; agent, producer and broker licensing issues; examination issues; corporate law and governance issues; compliance; fraud and abuse; MNRO and TPA licensing; holding company regulation; and “best practices” compliance. He is knowledgeable of regulatory issues affecting these industries on both the federal and state level, including Medicare, Medicare Advantage, Medicaid, and Medicaid managed care, as well as self-insurance issues. He has drafted numerous contracts for use in the banking, insurance, and healthcare fields, including provider agreements, management services agreements, and ancillary services agreements. He has published several articles on financial institution law, and given numerous lectures relating to insurance regulation, including to the Conference of Certified Fraud Examiners, on his experiences relating to insurance fraud matters while serving as outside counsel to the Louisiana Department of Insurance.
Mr. Herbert currently serves as the Vice-Chairman of the Health Law Section of the New Orleans Bar Association. He is also an active member of the American Health Lawyers Association, the Louisiana Association of Health Plans, and the Health Law Section of the Louisiana Bar Association. He previously served as a member of the Board of Directors and as the Secretary-Treasurer of the Louisiana Leukemia Society. In 2009, Mr. Herbert was named as one of the Top 50 lawyers in New Orleans by New Orleans CityBusiness.
Jennifer Warden Herbert focuses her practice on advising clients on a range of business and healthcare related transactional and litigation matters, including counseling healthcare providers, managed care organizations and facility owners in all facets of business and healthcare law. In her practice, Ms. Herbert regularly counsels clients on compliance and healthcare business issues, including negotiating healthcare and provider contracts and structuring business transactions. She has experience in assisting healthcare providers and organizations with practice management issues, reimbursement matters and conducting day-today business operation to ensure compliance with the Stark law, the Anti-Kickback Statute, Medicare and Medicaid participation and requirements, and professional licensing rules. Ms. Herbert has successfully represented clients in numerous Medicare and Medicaid matters, including victories in recovery audit appeals.
In her practice, Ms. Herbert has represented and assisted with business planning for corporations, limited liability companies, limited liability partnerships, limited partnerships, general partnerships and entrepreneurs, including healthcare providers and practitioners, in transactions including acquisitions and sales of businesses, mergers, joint ventures, trade regulation, non-competition agreements, non-disclosure and confidentiality agreements, shareholder disputes, non-profit and tax-exempt organizations, and general contract and business matters.
Ms. Herbert is presently the Secretary/Treasurer of the Health Law Section of the Federal Bar Association and Co-Chair of a Health Law Section Committee of the New Orleans Bar Association. She is also a member of the Louisiana and Mississippi Bar Associations, American Bar Association and American Health Lawyers Association.
Ms. Herbert received her Juris Doctor with certificates in common law and civil law from Loyola University in New Orleans. Prior to attending law school, Ms. Herbert received a Master of Business Administration with a concentration in Finance and Bachelor of Arts and Bachelor of Music degrees from Loyola University in New Orleans, LA.
Ms. Herbert is admitted to practice before all state and federal courts in Louisiana and Mississippi. Ms. Herbert lectures and writes frequently on managed care federal regulatory changes in healthcare and issues of interest to physicians and other healthcare providers.
REPRESENTATIVE CLIENTS
Health Maintenance Organizations and Other Benefit Plans: Amcare Health Plans of Louisiana, Inc.; CIGNA Healthcare; Community Care Network, Inc. (CCN, Inc.); Coventry Health Plan; First Health Group Corp.; Humana Health Plan of Louisiana, Inc.; Ochsner Health Plan; Ochsner/Sisters of Charity Health Plan, Inc.
Managed Care and Health Care Related Insurers: AETNA; CNA HealthPro; Columbia Casualty; Continental; St. Paul Fire and Marine; Peoples Health
Self Insured Plans: Reily Companies Group Medical and Dental Plan-Group Medical Benefits for Employees; Entergy Health and Welfare Benefits Plan
Third Party Administrators: ACMG, Inc.; Attenta; Benefit Recovery, Inc.; Dynamic Subrogation Solutions, L.L.C.; Southern Risk Services, Inc.; Trover Solutions, formerly Healthcare Recoveries, Inc.
Medical Device Manufacturers: St. Jude Medical
Health Care Collection Agencies: Crescent City Recovery, Inc.; Southern Credit Recovery, Inc.;
Compliance Vendors - HIPAA Standard Transactions: Dynamic Technical, L.L.C.
Providers: Alton Ochsner Medical Foundation; American Home Health Kare Providers, L.L.C.; American Society of Colon and Rectal Surgeons; Back To Health Chiropractic Clinic; Home Health Professionals, Inc.; Louisiana Cancer Consortium; Louisiana Organ Procurement Agency; Louisiana Pediatric Network; Ochsner Clinic; Ochsner Clinic Foundation; Ochsner Clinic Health Services; Corporation; Ochsner Home Health Services, Inc.; Ochsner Home Medicare Corporation; Ochsner Medical Institutions; Ochsner Organ Bank; Ochsner Service Corporation; RediCare Home Health Association; RediCare Services, Inc. d/b/a Kiddie Care Zone; South Louisiana Medical Associates; Thibodaux Regional Medical Center; Total Sleep Diagnostics, Inc.; Tulane Medical Center; Urology Clinic of Southwest Louisiana; Numerous Individual Physicians
Firm News
Barry H. Grodsky Installed as 78th President of the Louisiana State Bar Association Barry H. Grodsky, a partner in the New Orleans law firm of Taggart Morton, L.L.C., was installed June 7 during the LSBA’s Annual Meeting in Destin, Fla. Administering his oath of office was Louisiana Supreme Court Chief Justice Bernette Joshua Johnson. Grodsky has set several goals for his year as ... » Read More
