Lynsey Mitchel is an associate in the Corporate Practice Group in the firm's Century City office and is a member of the firm's healthcare practice team.
Areas of Practice
Lynsey represents hospitals, managed care organizations, medical groups, pharmacies, home health providers, medical device retailers and other healthcare entities and providers.
Lynsey has deep expertise in HMO regulatory matters and has assisted numerous clients to obtain HMO licensure as healthcare service plans under California's Knox-Keene Health Care Service Plan Act. Lynsey has represented approximately half of all currently licensed restricted Knox-Keene HMO license holders in California in their licensure process. Lynsey has worked on HMO licensure and other matters for Medicare Advantage, commercial and Medicaid health plans. Lynsey also assists health plans with regulatory compliance matters, material modifications, growth strategies, acquisitions and training.
In the managed care sector, Lynsey represents payors and providers participating in accountable care organizations (ACOs), bundled payment initiatives and other cutting edge risk-sharing arrangements. Lynsey works with national and regional health plans (including full service and specialty plans), as well as large health systems and physician groups, on a broad range of matters including population health management strategies, provider employment, risk-based, performance-based and value-based payor and provider contracting, compliance, acquisitions and physician alignment strategies.
Lynsey's practice is focused on licensing and other regulatory compliance matters, business transactions, patient privacy issues including HIPAA and HITECH Act compliance, and telemedicine, as well as Medicare and Medicaid reimbursement and certification. In addition, she counsels clients on state and federal fraud and abuse issues, including the Stark Law and anti-kickback and fee-splitting laws.
Recent Selected Operational and Contracting Projects:
•Structuring innovative “two-site, one program model” between large university health system and regional children's hospital to transform pediatric care delivered by the hospitals
•Assisting ambulatory surgery center client to establish innovative bundled payment arrangements focused on total joint and spine surgeries
•Assisting children's hospital to evolve to a multi-hospital health system and advising on physician integration strategies and population health initiatives
•Negotiating commercial ACO shared savings arrangements on behalf of an ACO made up of independent primary care physicians focused on business and practice transformation services
Publications & News
•MSSP ACO Program - Proposed Rule
AHLA, December 2014
•Co-Author with Florence Wang, The Affordable Care Act: What Every Business Lawyer Needs to Know, Vol. 29, California Business Law Practitioner, Spring 2014
•Co-Author with Mark A. Kadzielski, An Analysis of the New Federal Patient Safety Law and Final Rule, Vol. 11, Journal of Health Care Compliance, 2009
•Co-Author with Dayna Nicholson, A Medical Error Happened: Now What? The Implications for Medical Errors Heat Up, Vol. 10, Journal of Health Care Compliance, 2008
•Co-Author with Abbie Maliniak, Overview of the Current State of HIPAA Enforcement, Vol. 19, Managed Care Outlook, 2006
Healthcare Law Blog Posts
• CMS Redefines Alternative Payment Models and Offers Option for Merit-Based Incentive Payment System in New Proposed Rule, June 3, 2016
• New Amendments Grant Failing ACA Co-Op Program Access to Private Capital and Limit Special Enrollment Eligibility, May 17, 2016
• States Take Aim At Health Insurance Providers Fee In New Litigation, November 2, 2015
• Medicare Hospital Compliance Reviews are Legal and Sound, According to OIG, February 4, 2015
• What Can You Expect in 2015 Regarding HIPAA Enforcement? December 22, 2014
• Device Advice: New Guidance From the FDA on Medical Devices and Cybersecurity, October 14, 2014
• A (Second) Lawsuit Seeks to Compel Statutory Timeframe for Administrative Law Judge Review of Medicare Claims Appeals, September 11, 2014
• Bundled Payments under the Affordable Care Act Continue to Gain Influence, August 8, 2014
• High Rates of Unhealthy Enrollees in ACA Exchanges, July 1, 2014
• New CMS Hospice Item Set Reporting Invades Privacy Rights, June 18, 2014
• House committee questions authority of a DHHS staff division to regulate health IT, June 10, 2014
• HHS releases new software for updating (but not replacing) HIPAA security risk assessment toolkits, April 14, 2014
• Enforcement of the Two-Midnight Rule Delayed Again, April 7, 2014
• Interstate Medical Licensing Compact Could Pave a Smoother Path for Telemedicine Providers, March 27, 2014
• Accountable Care Organizations: Payment Options for ACOs Pursuant to the Proposed Rule, May 24, 2011
•Proposed Rule: Legal Structure and Governance of ACOS, April 12, 2011
• California's Department of Managed Health Care Announces ACOs Should Expect Licensure Requirement, January 26, 2011
• CMS Releases Self-Referral Disclosure Protocol for Stark Violations, November 29, 2010
• OIG Releases Fiscal Year 2011 Work Plan, November 29, 2010
•“Building Tailored Networks, ” Speaker at Pre-Conference, 10th Annual MDS Healthcare Leadership and Executive Conference, October 3, 2015
• Integrated Delivery Systems: Lessons Learned and New Contracting Challenges, CSHA Annual Meeting & Spring Seminar, April 17, 2015
•10th Annual MDS Healthcare Leadership and Executive Conference