Rachel’s practice involves a variety of regulatory, compliance, and transactional matters for a broad range clients across the health care industry, including health care systems, managed care organizations, pharmacies, device and pharmaceutical manufacturers, long-term and post-acute care providers, and private equity firms investing in the health care industry.
Rachel combines her industry knowledge and her deep understanding of the complex legal frameworks regulating the health care industry to provide her clients with practical, strategic guidance that supports innovation and business objectives. She is particularly well versed in the federal anti-kickback statute, the Stark Law, state fraud and abuse laws, beneficiary inducement prohibitions, provider-based rules, Medicare and Medicaid program requirements, and the federal Physician Payments Sunshine Act. She routinely advises clients on the legal, practical, and fraud and abuse implications of business arrangements and sales and marketing practices.
Rachel regularly assists with implementing effective health care compliance programs for clients in various health care sectors, including managed care organizations, health systems, and pharmaceutical manufacturers, to name a few. She has assisted both with developing brand new compliance programs for health care companies just starting out and maturing existing compliance programs to support health care companies’ efforts to expand. During a three-month secondment from Mintz, she also served as the interim chief compliance officer for a nonprofit managed care organization that offers Medicaid, Medicare Advantage, and Marketplace health plans.
On the transactional side, Rachel frequently serves as health care regulatory counsel in both M&A transactions and private equity investments, involving managed care organizations, pharmacies, and a range of health care providers. She has experience in complex due diligence, contracting matters, identifying fraud and abuse risks, and advising on regulatory issues relevant to the target.
Previously, Rachel was a compliance attorney with Sentara Healthcare, a health care system with 12 acute care hospitals and more than 300 sites of care in Virginia and North Carolina. Focusing on the physician contracting process, Rachel developed strategic solutions to operational problems and provided legal support for compliance issues across the system. Her in-house experience informs her pragmatic, business-savvy counsel to health care industry clients.
An active member of the American Bar Association’s Health Law Section, Rachel assisted in drafting several revisions to the group’s reference guide, Health Care Fraud and Abuse: Practical Perspectives, and organized and moderated a panel of senior government attorneys for an ABA networking event. She is frequently invited to speak on health care compliance and other health law matters. She is also an editor of and frequent contributor to the firm’s Health Care Viewpoints.
- Served as the Interim Chief Compliance Officer at CareSource, an Ohio managed care organization offering Medicaid, Medicare, and Marketplace plans.
- Acted as special counsel for the initial public offering of Blued, China’s largest LGBT dating app and surrogacy facilitator.
- Represented a health care provider in a self-disclosure to CMS for potential Stark Law violations.
- Represented a health care provider under investigation by the Department of Justice for alleged violations of the anti-kickback statute and Stark Law.
New Group Practice Information Form for the Stark Law’s Self-Referral Disclosure Protocol
February 2, 2023 | Blog | By Rachel Yount
Mintz Health Law: What We Are Grateful For
January 11, 2023 | Podcast | By Bridgette Keller
CMS Issues Additional Flexibilities to the ACO REACH Model’s Benefit Enhancements
December 16, 2022 | Blog | By Rachel Yount
CMS Announces Changes to the MSSP Designed to Increase MSSP Participation and Promote Equity within the MSSP
November 17, 2022 | Blog | By Rachel Yount
California Passes New Law Requiring Physicians and their Employers to Notify Patients about the Open Payments Database
October 11, 2022 | Blog | By Lara Compton, Rachel Yount
Pharmaceutical Manufacturer Pays $7.9 Million to Resolve Allegations that it Caused the Submission of Over-the-Counter Drugs to Medicare Part D
September 20, 2022 | Blog | By Joanne Hawana, Rachel Yount
Eighth Circuit Adopts Stricter But-For Causation Standard for False Claims Act Claims based on Anti-Kickback Violations
August 18, 2022 | Blog | By Kevin McGinty, Rachel Yount
OIG Issues Favorable Opinion on Federally Qualified Health Center’s Smartphone Loan Program
May 6, 2022 | Blog | By Rachel Yount, Jean D. Krebs
OIG Approves Physician-Owned Medical Device Company
April 28, 2022 | Blog | By Rachel Yount
OIG Issues Another Favorable Advisory Opinion on Treatment-Based Patient Incentives
March 15, 2022 | Blog | By Rachel Yount
News & Press
How New Kickback Rules Benefit Health Care Industry: Part 1
December 18, 2020
How New Kickback Rules Benefit Health Care Industry: Part 2
December 18, 2020
Events & Speaking
Reducing Patient Leakage by Directing Physician Referrals, AKS Safe Harbors, and Stark Law Exceptions
HHS’s Holiday Gift to the Health Care Industry: Historic Changes to the Anti-Kickback Statute and Stark Law Regulations
View the Webinar Recording
Co-author, What Is...The Anti-Kickback Statute?, Second Edition, Published by the American Bar Association (2022)Read less
Recognition & Awards
- Recognized by The Legal 500 United States for Healthcare: Service Providers (2021)
- Member, American Health Lawyers Association (2011-present)
- Member, Health Law Section, American Bar Association (2016-present)
- Vice Chair, Health Law Committee of the Young Lawyers Division, American Bar Association (2017-2018)
- Member, Health Care Compliance Association (2014-2016)
Rachel E. Yount