Ellyn has more than 30 years of legal experience, with an extensive background in the field of government health care enforcement.
Ellyn’s experience enables her to provide valuable insight to clients facing potential state or federal investigations, or who have general compliance concerns. Ellyn currently represents a variety of health care product and service providers in federal and state administrative, civil, and criminal matters around the country. She conducts internal reviews and investigations for clients concerned about potential compliance issues, including compliance investigations having to do with data security and privacy safeguards. Ellyn advises clients of proposed or existing health care acquisitions or business arrangements, especially those involving Medicaid, Medicare, and the 340B Drug Pricing Program. Ellyn serves as a mediator in health care disputes, including state and federal false claims cases.
Prior to joining Mintz, Ellyn spent more than 15 years as the director of the Oregon Department of Justice's Medicaid Fraud Control Unit, supervising investigations and prosecutions of criminal and civil health care billing fraud and patient neglect cases in both state and federal court. Ellyn handled a wide variety of complex health care cases, and developed specialized experience in qui tam false claims actions. Ellyn was the lead state attorney in multiple “global” health care matters, heading up major false claims investigations and settlements involving national and international health care providers. Ellyn co-chaired the National Association of Medicaid Fraud Control Units (NAMFCU) Global Case Committee for more than 10 years, and was instrumental in developing the processes in use today for coordinating federal and state false claims investigations. She also developed and presented training programs for government attorneys, auditors, and investigators who investigate and pursue false claims health care cases.
Ellyn previously served as the chief of the Consumer Rights Division of the Office of the Utah Attorney General, overseeing administrative, civil, and criminal consumer-based investigations and litigation. Ellyn began her legal career as a defense attorney with the Clayton, Missouri firm of Wolff and Frankel, and remains an avid fan of the St. Louis Cardinals baseball team.
Ellyn frequently speaks and writes on health care fraud and abuse matters, and is a contributor to the Mintz Health Law & Policy Matters blog.
- Washington University (JD)
- George Washington University (BA)
- Advised entities on compliance in the 340B Drug Pricing Program
- Represented national health care manufacturers and providers in multiple state and federal false claims litigation, resulting in favorable resolutions for the clients
- Evaluated potential risks of proposed business arrangements for national health care providers
- Advised national health care companies on state and federal regulatory matters, including potential affirmative litigation options
- Advised a global health care company on a variety of issues in connection with its acquisition of several health plans and provider groups, including health care regulatory due diligence, health care regulatory advice regarding transaction structure and strategy, and preparation of regulatory notices and other filings.
- Advised multiple pharmacy benefit managers and insurers on compliance concerns raised by state regulators pursuing inquiries on PBM and pharmacy claims processing practices, including issues specific to specialty drug arrangements, MAC pricing, and compliance with state-specific insurance requirements.
Recognition & Awards
- HHS OIG Integrity Award (2005)
- President's Council on Integrity and Excellence Award for Excellence (2005)
- Multiple Oregon Department of Justice Outstanding Service Awards
- NAMFCU President's Leadership Award
- NAMFCU Case Leadership Award
- Co-chair, National Forum on Pharmaceutical Pricing Litigation, American Conference Institute (October 2012)
- Past member, St. Louis County Metropolitan Task Force on Child Sexual Abuse
- Member, NAMFCU Global Case Committee (1998 – 2009)
- Co-chair, NAMFCU Global Case Committee (1999 – 2008)
- Past president, National Association of Medicaid Fraud Control Units
- Member, Washington University (St. Louis) Washington, DC Regional Cabinet
- Past board member, Jewish Family and Children Services of Oregon
- Past board member, Mittleman Jewish Community Center
- Past chair, Mittleman Jewish Community Center Kids Corner Committee
- Past member, Board of Advisors for St. Louis Warson House Home for Girls
News & Press
August 13, 2019 | Blog | By Ellyn Sternfield
July 30, 2019 | Blog | By Theresa Carnegie, Ellyn Sternfield, Matt Mora, Michelle Caton, Eli Greenspan
March 1, 2019 | Blog | By Ellyn Sternfield
340B, When a Price Adjustment is Not Really an Adjustment, and the Implications for CMS Efforts to Attack Drug Prices
January 2, 2019 | Blog | By Ellyn Sternfield
On December 27, 2018, Judge Rudolph Contreras granted the American Hospital Association’s Motion for a Permanent Injunction over CMS’ Medicare Part B reimbursement cut for 340B hospitals. As I have previously written, the vehicle for that reimbursement cut was the 2018 Outpatient Prospective Payment System (OPPS) rule, and CMS’ existing authority to adjust OPPS drug reimbursement.