
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.
Education
- Washington University (JD)
- George Washington University (BA)
Experience
- 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
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
Involvement
- 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
Viewpoints
CMS Ignores the Courts: 2020 Hospital Outpatient Prospective Payment System Final Rule Includes 340B Rate Cuts Already Ruled Unlawful
November 14, 2019 | Blog | By Ellyn Sternfield, Daryl Berke
CMS Takes Another Swing at 340B Reimbursement Cuts. Will It Be Strike Three?
August 13, 2019 | Blog | By Ellyn Sternfield
Senate Finance Committee Passes Drug Pricing Bill
July 30, 2019 | Blog | By Theresa Carnegie, Ellyn Sternfield, Michelle Caton
March 2019: Where Are We Now With 340B?
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.
Health Care Qui Tam Update
November 5, 2018 | Article | By Hope Foster, Kevin McGinty, Ellyn Sternfield, Benjamin Zegarelli
Six Initiatives States May Pursue to Curb Drug Prices and the 340B Factor
October 23, 2018 | Blog | By Ellyn Sternfield
CMS Proposes to Reduce Payments for New Drugs under Medicare Part B
July 20, 2018 | Blog | By Ellyn Sternfield
Court of Appeals Weighs in on 340B
July 18, 2018 | Blog | By Ellyn Sternfield
July 2018: Where Are We Now With 340B?
July 17, 2018 | Blog | By Ellyn Sternfield
News & Press
Here’s Why Your Tax Dollars Are Overpaying for Medicaid
January 2, 2019
Medicare Herds Four Anti-Fraud Programs Under One Roof
November 8, 2018
States Seek More Power to Fight Medicaid Home Patient Abuse
September 20, 2018
Enforcement Threat Grows for Hospital Opioid Theft
August 20, 2018
Lawmakers to Grade New Medicaid Anti-Fraud Strategy
August 20, 2018
Medicaid Payment Oversight Found Lacking
June 8, 2018
Medicaid Wastes Billions Despite Warnings
May 16, 2018
Feds Cracking Down on State Medicaid Programs
April 2, 2018
Lawmakers Set to Probe Medicaid Fraud and Waste
March 22, 2018
Are Medicare Anti-Fraud Efforts Flawed?
October 12, 2017
HHS Watchdog to Probe Medicaid Health Homes Program
September 20, 2017
Is Medicaid Doing All It Can To Stop Fraud?
September 14, 2017
Fraud and Abuse: Tool to Thwart Medicaid Fraud Used Sparingly by States
September 13, 2017
Medicare to Narrow Scope of Health-Care Provider Audits
August 23, 2017
Health-Care Watchdog to Review Medicaid Opioid Claims
July 18, 2017
Consolidation Comes to Health-Care Anti-Fraud Contractors
February 23, 2017
Health Fraud Rule Withdrawal May Hurt Enforcement Efforts
February 1, 2017
Medicare Drug Benefit's Catastrophic Spending Up Sharply
January 6, 2017
Government Watchdog Taking Close Look at Medicaid Drug Rebates
December 27, 2016
Medicaid Drug Rebate Program Under OIG's Watchful Eye
December 9, 2016
Pharmacy Cost-Sharing Waivers OK in New Fraud Rule
December 6, 2016
Medicare Still Making Improper Payments on Behalf of Prisoners
October 7, 2016
Senators Ask DOJ to Investigate EpiPen-Maker Mylan
September 28, 2016
Proposed Rule Would Bolster Medicaid Fraud Program
September 19, 2016
Republicans Seek Probe Into EpiPen's Medicaid Rebate Status
September 13, 2016
Final Rule Boosts Health-Care Penalties to Reflect Inflation
September 2, 2016
Medicare Gets Big Bang for Its Buck by Fighting Fraud
July 20, 2016
Government Cites Leap in Medicare Spending on Opioids
June 27, 2016
OIG Report Finds Indications of Fraud in Home Health
June 24, 2016
Health-Care Fraud Recoveries Soar in 2016
June 13, 2016
Report Calls for More Guidance on Medicaid Hospital Payments
March 14, 2016
Medicaid Program Integrity Bill
March 7, 2016
Events
3rd Annual Mintz /ML Strategies Pharmacy & Pharmaceutical Industry Summit
Mintz and ML Strategies
Boston, MA
