Nili helps health care clients understand and navigate the regulatory environment in order to maximize their business opportunities. She draws on her knowledge of federal and state laws to help clients structure complex transactions, design and implement compliance programs, and enter into professional services, consulting services and other arrangements that reduce their risk of liability under intricate regulatory frameworks such as corporate practice of medicine, anti-kickback, and self-referral (Stark) laws.
Nili counsels hospitals, large and small group practices, community-based providers of behavioral health and social services, managed care organizations and emerging companies in connection with various health care transactional matters such as joint ventures, mergers, acquisitions, divestitures and affiliations, primarily within the heavily regulated New York environment. She also assists tax-exempt hospital systems with medical staff matters, provider and third party payor contracts, executive compensation and corporate governance issues.
Nili also regularly advises her health care clients on state and federal regulatory compliance matters, including with respect to the corporate practice of medicine, telemedicine, and fraud and abuse, and consults with teaching hospitals and academic medical centers on ACGME accreditation issues.
Education
- Brooklyn Law School (JD)
- New York University (BA)
Experience
- Represented multiple managed care organizations in the sale and acquisition of commercial, Medicare and Medicaid plans.
- Represented a national behavioral health managed care organization in its initiative to staff employer-based clinics in 42 states with behavioral health care providers.
- Served as regulatory counsel in connection with a private equity company’s acquisition of a dental discount plan.
- Represented one of the largest kidney care providers in multiple joint venture arrangements, acquisitions and divestitures in New York and nationwide.
- Served as transactional counsel in the sale of renowned New York City pediatric ophthalmic practice.
- Served as regulatory counsel to a large hospital system in connection with the sale of its outreach laboratory to a national laboratory service provider.
Recognition & Awards
- Chambers USA: New York – Healthcare (2018-2020)
- Included on the New York Super Lawyers Rising Star: Health Care list (2014 - 2015)
- Best Lawyers in America: Healthcare Law (2020)
Involvement
- Member, New York Bar Association
- Member, American Healthcare Lawyers Association
Recent Insights
Viewpoints
New York Seeks to Add Greater Protections Against Surprise Bills
October 14, 2019|Blog
New York (Again) Seeks to Regulate Pharmacy Benefit Managers
March 15, 2019|Blog
New Jersey Regulates Out-Of-Network Billing
August 31, 2018|Blog
News & Press
Viewpoints
New York Seeks to Add Greater Protections Against Surprise Bills
October 14, 2019 | Blog | By Nili Yolin
Last week, the New York State Department of Financial Services released a proposed amendment to the regulations promulgated under the State’s Emergency Medical Services and Surprise Bills law (the SBL), which adds additional notice requirements for insurers and out of network (OON) providers.
Read more
New York (Again) Seeks to Regulate Pharmacy Benefit Managers
March 15, 2019 | Blog | By Nili Yolin
On January 15, 2019, Governor Cuomo released the 2019-2020 Executive Budget, which proposes substantial legislative changes that would affect pharmacy benefit managers (PBMs). Among other things, the law would require PBMs to be licensed and places limitations on how they can be compensated. This week, the State Senate released its own Budget that, while joining the Governor's efforts to regulate PBMs, purports to create additional safeguards around PBM business activities, including increased financial penalties on PBMs that violate the law.
Read more
New Jersey Regulates Out-Of-Network Billing
August 31, 2018 | Blog | By Bridgette Keller, Nili Yolin, Hope Foster
News alert for all New Jersey health care providers! A new law went into effect yesterday (August 30, 2018) that changes billing requirements for out-of-network services in New Jersey.
Read more
New York Executive Budget Proposes Corporate Ownership of Retail Clinics, Tax on Not-for-Profit Health Insurance Conversions
January 25, 2018 | Blog | By Nili Yolin
Last week, Governor Andrew Cuomo unveiled his proposed $168 billion budget for fiscal year 2019, which proposes several changes to New York’s healthcare landscape.
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OIG Reaffirms Permissibility of Certain Gainsharing Arrangements
January 10, 2018 | Blog | By Ryan Cuthbertson, Nili Yolin
The Department of Health and Human Services Office of the Inspector General (OIG) has issued an Advisory Opinion (Opinion) in connection with a hospital’s gainsharing arrangement (Arrangement) with a designated group of neurosurgeons who perform spinal fusion surgeries at the hospital.
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New York Medical Society Warns Providers to Avoid Percentage-Based Fees
March 21, 2017 | Blog | By Nili Yolin
A series of recoupment letters from the New York State Medicaid Fraud Control Unit (MFCU) to healthcare providers who have management or billing company arrangements based on a percentage of collections has prompted the Medical Society of the State of New York (MSSNY) to warn its members that such arrangements are fraudulent under Medicaid law.
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California Joins New York and Florida, Passes Out-Of-Network Legislation
September 19, 2016 | Blog | By Nili Yolin
Last month the California legislature passed AB-72, which amends the Health & Safety Code to address reimbursement for out of network (OON) providers who provide services at in-network facilities, such as hospitals and laboratories.
Read more
After New York, Florida Curbs Surprise Bills for Emergency and Out-of-Network Services
April 28, 2016 | Blog | By Nili Yolin
It is generally understood that if a managed care member utilizes the services of a non-participating provider, the member could incur significant out of pocket expenses. However, there are instances where a member may unknowingly receive services from an out-of-network provider, such as a radiologist or anesthesiologist, while receiving emergency or non-emergency care at an in-network hospital.
Read more
CMS Takes Action Against Network Transparency While New Jersey Legislation Hits a Snag
February 10, 2016 | Blog | By Nili Yolin
Just as the Centers for Medicare & Medicaid Services (CMS) began holding federal health care plans accountable for their provider network transparency obligations, the New Jersey legislature stalled in its bid to pass a law that would require hospitals and physicians to disclose whether they are in or out-of-network with a patient’s insurance plan before providing treatment.
Read more
“Two-Midnight” Rule Needs Tweaking, Says Federal Judge
September 28, 2015 | Blog | By Nili Yolin
A Federal Judge found that the Department of Health and Human Services (DHHS) failed to comply with the Administrative Procedure Act (APA) when it cut hospital inpatient payments by 0.2% as part of its “two-midnight” rule.
Read more
News & Press
Mintz Recognized by Chambers USA 2019
April 26, 2019
Chambers USA 2018 Ranks Mintz Attorneys & Practices
May 03, 2018
Mintz partner and Massachusetts lawyer Julie Korostoff is one of 49 attorneys recognized as “Leaders in Their Fields” by the 2018 Chambers USA: America's Leading Lawyers for Business guide. Chambers named Korostoff a “Recognized Practitioner” in Technology.
Thirteen attorneys from Mintz have been named New York Super Lawyers for 2014 and eleven have been named New York Rising Stars. The list will be published in a special advertising supplement in The New York Times Magazine and in a stand-alone magazine, New York Super Lawyers - Metro Edition.
Events
Speaker
Apr
8
2019
Lawline Webinar
Managing Disruptive Physicians in the #MeToo Era
Panelist
Feb
5
2019
AHLA's Physicians and Hospitals Law Institute
Promoting Medical Staff Professionalism in the #MeToo Era
San Antonio, TX
Speaker
Feb
1
2017
Mintz and Grant Thornton Present a Multitopic CLE Workshop
Grant Thornton 757 3rd Avenue and 47th Street New York, NY
Speaker
Jan
29
2015