Jolie N. Havens
Ms. Havens is a partner in the Vorys Columbus office and a member of the health care group. She specializes in health care compliance and reimbursement, and employee health and welfare benefits. Ms. Havens has counseled adult and children's hospitals, physicians, pharmacies and pharmacy benefit managers, physicians, home health agencies, ambulatory surgery centers, diagnostic centers, and faculty practice plans on legal issues involving:
- payer enrollment, registration, licensure, and accreditation;
- Medicare and Medicaid billing, coding, documentation, coverage, and reimbursement, including obtaining provider-based status for both on-campus and off-campus facilities;
- compliance with federal and state fraud and abuse laws, including the federal Anti-Kickback Statute, the federal Stark Physician Self-Referral Laws, the federal False Claims Act, and related government investigations and audits;
- teaching physician and non-physician practitioner supervision and billing;
- other health care laws, including the Health Insurance Portability and Accountability Act (HIPAA) and the Emergency Medical Treatment and Active Labor Act (EMTALA); and
- professional disciplinary actions.
Ms. Havens also advises employers and group health plans in all industries on compliance issues related to the Employment Retirement Income Security Act (ERISA), the Consolidated Omnibus Budget Reconciliation Act (COBRA), the Uniformed Services Employment and Reemployment Rights Act (USERRA), HIPAA privacy, security and portability, Medicare Part D, and Medicare secondary payer and coordination of benefits issues. Ms. Havens routinely negotiates contractual arrangements with third party administrators and pharmacy benefit managers.
Her notable experience includes:
- acting as lead counsel to a national pharmacy benefit manager/mail-order and specialty pharmacy;
- representing a multi-state hospital in a multi-million dollar False Claims Act investigation, including formulation and implementation of medical records and claims review protocols, negotiations with the Department of Justice and analysis of overpayment liability;
- representing a large, urban university relative to expansion and day-to-day operations of a physician managed care network, including drafting new managed care agreements for use with participating physicians/groups and assisting with physician terminations and appeals;
- representing hospitals and physician groups relative to alignment and integration strategies, including negotiating physician employment arrangements, space and equipment leasing, and practice leasing and asset purchase agreements.
Ms. Havens regularly speaks both nationally and locally on health care reform policy and compliance, and publishes often on the subjects.
News
- Vorys Elevates Six Attorneys to Partner
- Havens Quoted in Columbus C.E.O. Article "Kill or Cure"
- Dunsizer and Havens Quoted in The Daily Reporter article "Employers Could Lose Grandfathered Status for their Health-Care Plans"
Events
- Labor and Employment Update-2011
- Health Care Reform Update: False Claims Act Compliance & Health Plan Mandates
- HITECH Compliance for Health Providers and Health Plans
- Masters Series: Health Care Reform
- Health Care Reform: Moving from Theory to Implementation - an overview of new guidance, strategies and case studies
- Health Care Reform: Data, Deadlines and Disclosures
- Health Care Reform: What do I have to do and when do I have to do it?
- OPRA Annual Spring Conference
Publications
"Healthcare Providers as Employers: Key Developments in Employee Health Benefits Under the PPACA, "American Health Lawyers Association Healthcare Reform Law Resource Guide, July 2010
"Compliance with the new Mental Health Parity and Addiction Equity Act," Compliance Today, July 2009
- Client Alert: Update on Reporting the Cost of Health Coverage on Form W-2
- Client Alert: States to Define "Essential Health Benefits" and Other Employee Health Benefits News
- Client Alert: Summaries of Benefits and Coverage on Hold and Other Employee Benefits News
- CMS Releases Interim Final Rule for ACO Fraud & Abuse Waiver Provisions
- Client Alert: DOJ and FTC Release Antitrust Policy for ACOs
- Client Alert: CMS Releases ACO Final Rule
- Client Alert: 200+ Pages of Guidance on How to Construct a 4-Page Summary of Benefits and Coverage...
- Labor and Employment Alert: New Guidelines for Women’s Preventive Care Services
- Client Alert: Claims, Appeals and External Review Rules Liberalized
- "Final Rule Update: New Enrollment and Payment Suspension Rules Affect All Medicare, Medicaid, and CHIP Providers and Suppliers"