The No Surprises Act, which was enacted to protect patients in situations where their provider is not contracted with their insurer, has heavily impacted providers and insurers alike. Over the past few years, there have been a number of modifications to the regulations and ongoing litigation regarding the No Surprises Act. Topics will include:
- Overview of statutory and regulatory history
- What providers need to know to ensure compliance
- How claims are paid when a provider is non-contracted
- How to pursue claims in the IDR process
- Current litigation
- How the No Surprises Act has impacted provider and insurer contract negotiations
Heather Boysel is an experienced litigator and a leader for a wide range of clients in the healthcare space. Having secured millions of dollars for hospital clients from healthcare insurers, she is adept at navigating complex medical reimbursement disputes on clients’ behalf. Heather combines her legal savvy with a strong understanding of healthcare payment methodologies, ensuring her clients receive unmatched service and industry insight. As Leader of Gammage & Burnham’s Healthcare Practice Group, Heather focuses on commercial litigation with a particular emphasis on the healthcare sector. She routinely handles medical reimbursement disputes, representing healthcare providers against commercial payors, Medicare auditors, AHCCCS contractors, and other governmental entities. Her comprehensive understanding of the legal protections and intricacies of healthcare payment methodologies—including AHCCCS, Medicare DRG payments, per diem payments, and healthcare provider liens—enables her to effectively advocate for her clients’ interests. Heather provides valuable assistance to healthcare providers regarding regulatory compliance and governmental audit issues. Her background in bioengineering and medical billing enhances her fluency in representing healthcare providers in reimbursement issues, whether through administrative hearings, mediations, arbitrations, or court actions. This unique blend of legal knowledge and technical mastery positions her as a trusted ally for clients navigating the complexities of the healthcare system.
Heather’s commitment to her clients and her thorough understanding of the healthcare landscape make her an invaluable asset to those seeking effective legal representation in commercial litigation.
Brian O’Sullivan formed The O’Sullivan Group, Inc. to serve health care providers with managed care and provider business development services. Over the years The O’Sullivan Group has also been sought out by Medicare Advantage and Managed Medicaid plans to assist with network development needs. Brian O’Sullivan is a seasoned industry professional and prior to forming The O’Sullivan Group, worked as Vice President Business Development, Marketing & Managed Care for an integrated hospital and physician organization. Additionally he has work in all types of payor environments including – Commercial, Medicare Advantage, Medicaid Acute, DD, Long Term Care, Tribal/Indian Health, and Workers Compensation, Behavioral Health, Dental and Specialty Pharmacy.
Brian leads client and business development activities and supports all client engagement teams in the following areas:
- managed care contracting
- provider enrollment and credentialing
- payor relations
- revenue cycle review
- fractional practice management
- business development
- program development
Mr. O’Sullivan has over thirty years of experience, working for both payors and providers. He is a skilled and passionate communicator, presenter and negotiator. He is very solutions and outcomes oriented.
Location
This program will be a hybrid program with both an in-person and virtual option. Please select the appropriate ticket for whether you intend to be in-person or virtual. Lunch will be provided to those in-person. The Zoom information will only be provided to those who purchase virtual tickets.
To Register
Regardless of membership, you must login to purchase tickets. To do so:
- Under ticket information, click “login to purchase”
- This will take you to the login page. If you are a member, use the login information utilized for your membership. If you are a non-member, you will need to create an account to purchase a ticket. Non-members who have not created an account yet, must select “Register” along the bottom next to “Lost your password?”
- From there, you will create an Account by entering a username, name, email address, and password. Then select “Complete Sign Up.”
- The account will need to be activated by using the link in a confirmation email sent to the registered email address. Once the account is activated, you will login using the credentials provided (username and password).
- Once logged in, navigate to the Program page and select the number of tickets needed and select “Get Tickets” to proceed with the checkout process.
Should you have any questions or issues with the registration process, please contact us at [email protected].
Once you have registered online, you will receive a calendar invitation and information about attending or accessing the program, depending on ticket type. The program cost is as follows:
- Member – $20
- Non-Member – $40
- Student Member – $5
- Student Non-Member – $25
Interested in becoming an AzSHA Member? Sign-Up Here.
The State Bar of Arizona does not approve or accredit CLE activities for the Mandatory Continuing Legal Education requirement. This activity may qualify for up to 1 hour of CLE credit, 0 hours of ethics, toward your annual requirement for the State Bar of Arizona.