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Melissa Goldman

Associate

Melissa advises clients on health care regulatory compliance with particular attention to telehealth, digital health, and health care technology.

Professional Biography

Overview

Melissa advises clients on health care regulatory compliance with particular attention to telehealth, digital health, and health care technology. Ms. Goldman anticipates potential issues providing practical and strategic counsel to health care providers and technology companies on innovative relationships, business models, and reimbursement opportunities that address regulatory requirements while effectively and efficiently meeting clients' business objectives.

As former associate general counsel and interim Chief Compliance Officer at one of the United States' largest telehealth companies, Melissa has a depth of experience advising on a broad range of health care technology issues, including federal and state fraud and abuse issues, federal and state privacy and security issues, Medicare, Medicaid and third-party billing and compliance requirements, state licensure, credentialing, and accreditation matters, and structuring arrangements with third parties (such arrangements include, billing services, management services, consulting services, vendor services, provider services, managed care contracts, credentialing delegations, and technology licensing).

Representative Matters
  • Assisted a national multi-specialty group in the development of a clinically integrated network of providers including the evaluation of corporate structure, health care regulatory issues, and preparation of key documents such as participation agreements and clinically integrated network policies and procedures.

  • Negotiated national managed care contracts and delegation of credentialing agreements with commercial payors, Medicare Advantage plans and Medicaid managed care plans.

  • Advised on multistate marketing arrangements for various health care entities such as DME providers, substance abuse providers and clinical laboratories.

  • Counseled and defended client through an investigation by the United States Office of Civil Rights in response to a complaint regarding HIPAA security violations.

  • Assisted as part of special health care counsel in a False Claims Act case against DME manufacturers and suppliers where the government intervened.

  • Counseled client through Medicare Advantage FDR audit process, including the establishment of a comprehensive Medicare compliance scheme within a very aggressive time frame. Drafted all the documentation and advised on the systems the client needed to demonstrate that it was, and would continue to be, in compliance with Medicare requirements. Remained mindful of client's business operations and ensured that compliance documentation be in harmony with and would not adversely impact client's actual operations.

  • Drafted and submitted comments to proposed state telemedicine legislation on behalf of a national behavioral telehealth company.

  • Prepared multistate surveys on informed consent laws, facility and clinic licensing and certificates of need laws, minor consent laws, fraud and abuse laws, provider scope of practice laws, telehealth reimbursement laws, and privacy and security laws.

  • Prepared and advised on Medicare Provider Enrollment forms for part A and Part B providers.

Speaking Engagements
Press Releases

Education

  • University of Miami School of Law, J.D., 2012, cum laude
  • University of Central Florida, B.S. in Hospitality Management, 2009

Admissions

  • Florida, 2012

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