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GeneLaks

Of Counsel

"My approach is to understand client business issues and objectives and assist them in resolving complex transactional and government audit, reimbursement, and enforcement matters."

Overview

Biography

The former counsel to the NYS Health Planning Commission with over 50 years of legal experience, Gene concentrates his practice on health care law. He advises health care providers and practitioners on Medicaid, Medicare, and third-party reimbursement; audits and appeals; federal and state statutory and regulatory compliance; managed care; Certificate of Need and professional licensing; and business organizations and affiliations.

Gene also provides transactional analysis for federal and state regulatory compliance and counsels on avoiding violations of the Stark Law and regulations prohibitions on self-referral and complying with anti-kickback laws and regulations.

Gene’s clients include health care practitioners and licensed public, not-for-profit, and proprietary health, mental health, alcohol- and other substance-use disorders, and developmental-disabilities agencies.

Bar Associations

  • New York State Bar Association, Health Care Reimbursement CLE Program Faculty Member

Selected Memberships & Affiliations

  • American Health Lawyers Association
  • New York State Bar Association Health Law Committee
  • Healthcare Financial Management Association
Experience

Representative Experience

  • Drafted the NY Health Care Reform Act of 1996 and the NY Prospective Hospital Reimbursement Methodology.
  • Drafted NYS legislation relating to nursing home, clinic, and home health care reimbursement under the Medicaid program.
  • Represents health care providers and practitioners in Medicaid, Medicare, and commercial payor audits and achieved numerous claim reductions and terminations of proceedings.
  • Advises health care providers and practitioners on Medicaid, Medicare, and commercial payor reimbursement and compliance matters.
  • Advises health care providers and practitioners in business transactional matters.
  • Advises health care providers and practitioners on operational and regulatory compliance issues, including anti-self-referral and anti-kickback laws.
  • Represented a managed care organization regarding state regulatory filing requirements
  • Represented an IPA relating to its business operations.
  • Brought an Article 78 proceeding against the Office of Mental Health to eliminate COPS payment recoupments and negotiated a settlement where the client paid less than what was demanded.
  • Served as counsel in a trial in which the NYS Department of Health (DOH) and the NYS Office for People With Development Disabilities (OPWDD) were found responsible for funding the reasonable actual costs of administrative overhead in providing services under Medicaid.

Prior Experience

  • Hiscock & Barclay, LLP, Of Counsel
  • NYS Department of Health, Assistant Counsel
  • NYS Health Planning Commission, Counsel

Selected Community Activities

  • New York State Partnership to Improve End-of-Life Care

Selected Honors

  • NY Department of Health, Special Achievement Award, 1988
  • New York State Health Planning Commission, New York Governor’s Citation, 1984
Knowledge

Selected Speaking Engagements

  • New York State Bar Association, “Long-Term Care Services, Regulatory Environment”
  • Lorman Educational Services, “Medicare, Medicaid, and Medical Assistance in New York”
  • Healthcare Financial Management Association, “Medicare and Medicaid Reimbursement”
  • Healthcare Financial Management Association, “Compliance Update”
  • OASAS, “Medicare and Medicaid Compliance Plans”

Selected Publications & Media

  • Healthcare Association of New York State New York Medicaid Reimbursement Guide: “Alcoholism and Substance Abuse Services,” “Chemical Dependence Services,” “Clinics,” “Compliance Plans and Audits,” “Health Care Practitioners,” “Health Care Suppliers and Vendors,” “Home Care Services,” “Hospitals,” “Managed Care,” “Mental Health Services,” “Mental Retardation and Developmental Disabilities Services,” and “Nursing Homes” Chapters
  • New York State Bar Association Health Law Journal, “Bounty Amid Scarcity: The Health Care Workforce Legislation”

Selected Alerts & Blog Posts

Featured Media

Alerts

NYS Courts to Implement Early Mandatory Mediation

Alerts

Takeaways From the USDA Interim Final Rule on Domestic Hemp Production

Alerts

The SHIELD Act: Update

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