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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.
  • Successfully obtained injunctive relief during the COVID-19 shutdown on behalf of an OPWDD provider enjoining the determination of DOH and OPWDD not to recalculate the provider’s recently issued group day habilitation Medicaid reimbursement rate. The matter was ultimately remanded for a recalculation of the rate.
  • Successfully represented several NYS fiscal intermediaries before OPWDD, resulting in the cessation of withholding 20 percent of non-Medicaid local assistance payments.

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

  • The Best Lawyers in America®: Health Care Law, 2023
  • 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 Governor Hochul's Budget Places the Future of the CDPAP RFO in Doubt

Alerts

Website Accessibility Lawsuits: Mizrahi Kroub LLP, Attorneys for Serial Tester Plaintiffs, Now Targeting Businesses in New York State Court

Alerts

NYS Governor Hochul Vetoes Proposed Grieving Families Act

Alerts

New Notification Requirements for Industrial Development Agencies

Alerts

HHS OCR Bulletin: Health Care Providers' Websites and Apps Could Contain HIPAA-Noncompliant Tracking Technologies

Alerts

EPA Finalizes Waters of the United States Rule

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