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PRACTICE AREAS

Managed Health Care Industry Services

Effective representation of today's managed health care industry requires an array of legal skills delivered in a cost-conscious fashion, coupled with a thorough knowledge of the industry and an excellent grasp of the ever-changing regulatory environment.

Lawyers at Taggart Morton have represented participants in all facets of the health care industry -- health maintenance organizations, managed care insurers, self-insured employer sponsored benefit plans, third party plan administrators, hospitals, nursing homes, single-specialty and multi-specialty physician practices, health care consultants and management service organizations, inventors of medical devices, manufacturers of medical devices, distributors of medical devices, suppliers of durable medical equipment and medical supplies, home health care agencies, medical billing and collection companies, and provider networks. Projects for these clients have required the business, tax, antitrust, litigation, labor and employment law, technology and qualified plan expertise of firm lawyers as well as the expertise of firm lawyers necessary to daily work in the managed health care environment.

The members of Taggart Morton's Health Group participate in numerous industry professional organizations and frequently offer presentations to industry groups, yet manage to set aside time to keep abreast of new legal developments. With this diversified legal experience and substantial knowledge of the industry, Taggart Morton's Health Group is uniquely positioned to meet the legal needs of its clientele. Biographies of Taggart Morton Health Group lawyers and some examples of the Group's experience in various segments of the industry follow.

Managed Care Industry Practice

•  Accreditation - Member Services
•  Antitrust & Trade Regulation - Medical Claims & Provider Billing
•  Arbitration & Mediation - Medicare & Medicaid
•  ERISA, COBRA & HIPAA - Medicare+Choice
•  False Claims Act - OIG Compliance
•  Fraud & Abuse - Provider Contracting & Credentialing
•  Health Care Collections - Subrogation & Third Party Recovery
•  Litigation - all state and federal courts - Utilization Review/Medical Necessity

Personnel:

Perry R. Staub, Jr. | Larry E. Demmons
Julie Rodrigue | Leslie Rozycki|

PERRY R. STAUB, JR.

Perry Staub chairs both the Litigation and Health Care Practice Groups at Taggart Morton. Mr. Staub has been involved in the representation of health care entities, including managed care entities, for over twenty years. Perry specializes in health and managed care litigation, including: ERISA, provider contracting, employment and labor law, antitrust & trade regulation, False Claims Act, intellectual property, technology, subrogation and third party reimbursement actions, Medicare, and all manner of business and complex litigation disputes. In addition to his practice in various state and federal courts nationwide, Perry has been involved in cases and regulatory proceedings before the Department of Justice, the Federal Trade Commission, the Department of Labor, the Health Care Financing Administration (now CMS), the Louisiana Department of Insurance and the Louisiana Department of Labor. Perry lectures extensively on issues of interest in the health care industry, as well as on the developing use of technology in both legal and business contexts.

Mr. Staub's interest in technology has led to his involvement in the n egotiation and preparation of medical technology licensing agreements; acquisitions and divestitures of medical technology; joint venture and "partnering" arrangements between developers of medical technology and manufacturers and distributors; encryption issues; counseling on online provision of medical services and on application of HIPAA's Medical Privacy and Transaction Standards.

Mr. Staub presently serves on the Board of Directors of the New Orleans Bar Association, where he also chairs the Technology Committee. He is a member of the American Health Lawyers Association, the Managed Care Interest Group of the AHLA; the Technology Practice Group of the AHLA; the American Bar Association (Sections on Health Law, Antitrust & Trade Regulation, Litigation, Science & Technology, Employment & Labor (ERISA), and Tort & Insurance Practice); the Health Care Compliance Association; the Louisiana State Bar Association's Health Law Section.

Perry Staub's profile

LARRY E. DEMMONS

Larry E. Demmons is a shareholder with the law firm of Taggart Morton and a member of its Managed Health Care Practice and Commercial Litigation Groups. Mr. Demmons also chairs the firm's Labor and Employment Practice Group. In the managed care arena, he represents both health care providers and health plans on litigation-related issues. His practice areas include ERISA benefits litigation, subrogation and other reimbursement claims brought by health plans, labor and employment issues, and contract-related litigation brought by healthcare and other managed care service providers.

Mr. Demmons is a member of the Order of the Barristers and the American, Louisiana and New Orleans Bar Associations. He is further licensed to practice in Louisiana state courts, before the United States Courts of Appeals for the Fifth, Seventh and Federal Circuits, and the United States District Courts for the Eastern, Middle and Western Districts of Louisiana , the Northern District of Illinois and the Middle District of Florida.

Larry Demmons' profile

JULIE E. RODRIGUE

Julie E. Rodrigue recently returned to Louisiana after a two year stint providing consulting services to health care entities while in California . Prior to her consulting engagement, Julie had served as Vice-President and Legal Counsel for a large healthcare delivery system (500+ bed tertiary hospital and 500+ physician group practice) with 30 locations, 5,000 employees and the largest HMO in Louisiana ($900 million system-wide revenue and over one million patient visits). Providing services in 40 medical specialty areas, as well as operating a multi-organ transplant center, cancer center, home health company, medical education and research programs, Ms. Rodrigue's original focus was assessment of legal and risk needs of the entire system and the design and management of programs to minimize legal risks and ensure financial performance. This position evolved quickly into a general counsel position in rapidly changing organization requiring leadership, outstanding problem solving and people skills and ability to act quickly and effectively. In that environment, Ms. Rodrigue reported directly to the CEO with system-wide responsibility for legal aspects of contract administration, general business matters, company litigation, risk financing, human resource and employment issues, corporate compliance, marketing and business development programs, employee and executive education, day to day problem solving and legal advice to all levels of organization. Ms. Rodrigue attended all company Board meetings as legal advisor to the Board and CEO.

Further job responsibilities included engagement, coordination and oversight of local and national law firms and consulting firms responsible for handling all company disputes and litigation matters. Julie also developed, implemented and supported a corporate compliance program and established a review and update process to ensure ongoing compliance efforts.

Ms. Rodrigue designed and managed a system-wide self-administered claims program resulting in multimillion dollar reduction in reserves and corresponding multimillion dollar savings to company. She designed medical staff credentials for the hospital, group practice and managed care plans; drafted hospital and ambulatory surgery center by-laws; oversaw and participated in numerous successful JCAHO accreditation surveys; and conducted regulatory compliance, insurance, business and legal programs throughout system.

Ms. Rodrigue is admitted to practice in both Louisiana and California . She is a member of the Louisiana State Bar Association's Health Law Section, the American Health Lawyers Association, the Women's Healthcare Executive Network.

LESLIE ROZYCKI

Leslie Rozycki brought to Taggart Morton twenty-five plus years of healthcare experience at the management/administrative level. Before embarking on a legal career at Taggart Morton, Leslie Rozycki served as Senior Network Manager for Aetna U.S. Healthcare from 1997 to 2001. In this capacity, Leslie managed Aetna's provider relation network management staff for Louisiana and Arkansas . Her responsibilities included network strategy and implementation, financial analysis of existing and new contracts against targeted medical per member/per month cost, review of plan financial performance, management of medical loss ratios and oversight of provider contracts. Ms. Rozycki was responsible for facilitating and monitoring all network contract negotiations, including fee for service, shared risk, capitation, case rates, per diem and DRGs. Her contracting responsibilities extended to language negotiations that n ecessitated a thorough understanding of applicable federal and state laws. Ms. Rozycki also ascertained compliance with NCQA accreditation requirements and had direct interaction with the accreditation team during reviews. She further provided support for the UR/QM and credentialing processes. Her job responsibilities also included management of dispute resolution with both providers and members, including arbitration, collaborating with internal counsel as necessary. In addition, Ms. Rozycki participated in committees with the Louisiana Department of Insurance in an attempt to develop a common physician credentialing process for all health plans.

  Prior to accepting her position at Aetna, Ms. Rozycki acted as Manager of the Healthcare Services Division of the New Orleans accounting firm Laporte, Serte, Romig & Hand. Her responsibilities there included: working with healthcare clients to ensure that billing practices met federal requirements; conducting accounts receivable billing/collections seminars; developing programs to streamline processes for TPA's and to optimize reimbursement; chargemaster maintenance and client direction. Ms. Rozycki proved uniquely suited to these tasks by virtue of her previous ten years of service as a head nurse and administrative supervisor at various health care providers.

  Ms. Rozycki received a Masters of Science in Health Services Administration from

Central Michigan University in Mount Pleasant , Michigan in 1988. She earned her BSN from Michigan State University in 1983 and completed the coursework for her MSN at Louisiana State University . She is a past President of the American Heart Association Board and has current memberships in the Greater New Orleans Medical Group Management, the Healthcare Financial Management Association and the National League for Nursing Advanced Certified Nurse Administrator. 

REPRESENTATIVE CLIENTS

Health Maintenance Organizations and Other Benefit Plans:

Amcare Health Plans of Louisiana, Inc.

CIGNA Healthcare

Community Care Network, Inc. (CCN, Inc.)

Coventry Health Plan

First Health Group Corp.

Humana Health Plan of Louisiana, Inc.

Ochsner Health Plan

Ochsner/Sisters of Charity Health Plan, Inc.

Managed Care and Health Care Related Insurers:

CNA HealthPro

Columbia Casualty

Continental

St. Paul Fire and Marine

Self Insured Plans

Reily Companies Group Medical and Dental Plan-Group Medical Benefits for Employees

Entergy Health and Welfare Benefits Plan

Third Party Administrators

ACMG, Inc.

Attenta

Benefit Recovery, Inc.

Dynamic Subrogation Solutions, L.L.C.

Southern Risk Services, Inc.

Trover Solutions, formerly Healthcare Recoveries, Inc.

Medical Device Manufacturers

St. Jude Medical

Health Care Collection Agencies

Crescent City Recovery, Inc.

Southern Credit Recovery, Inc.

Compliance Vendors - HIPAA Standard Transactions

Dynamic Technical, L.L.C.

Providers

Alton Ochsner Medical Foundation

American Home Health Kare Providers, L.L.C.

American Society of Colon and Rectal Surgeons

Back To Health Chiropractic Clinic

Home Health Professionals, Inc.

Louisiana Cancer Consortium

Louisiana Organ Procurement Agency

Louisiana Pediatric Network

Ochsner Clinic

Ochsner Clinic Foundation

Ochsner Clinic Health Services Corporation

Ochsner Home Health Services, Inc.

Ochsner Home Medicare Corporation

Ochsner Medical Institutions

Ochsner Organ Bank

Ochsner Service Corporation

RediCare Home Health Association

RediCare Services, Inc. d/b/a Kiddie Care Zone

South Louisiana Medical Associates

Thibodaux Regional Medical Center

Total Sleep Diagnostics, Inc.

Tulane Medical Center

Urology Clinic of Southwest Louisiana

Numerous Individual Physicians

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