Overview

Health care providers such as hospital systems, physician organizations, behavioral health providers, and laboratories, as well as insurers, employers, and technology vendors, look to attorney Jackie Selby to address their unique managed care issues and prevent disputes over reimbursement, network participation, and regulatory compliance challenges.

In addition, Jackie uses her experience with both corporate transactions and managed care to assist providers and insurers with joint ventures as well as to help startup technology companies commercialize innovations in health care and life sciences.

The industry’s shift to value-based payments creates new demands in data collection and sharing, reimbursement, rates, and other areas. Clients appreciate the high standards that Jackie sets and best practices she introduces for their long-term success. For example, a large health system client expanded its relationship with a tech-driven insurer to include a co-branded Medicare Advantage product. Jackie applied her understanding of plans, state regulations, and risk profiles to close the strategic deal—on budget and on time.

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Fast-growing companies, from clinical laboratories to providers of behavioral health, telemedicine, and disease management and care management services, count on her 50-state regulatory counsel and contract protections to launch new services and products. Jackie’s insights on the pitfalls of contracting reduce uncertainty for entrepreneurs and enterprises transforming health care. Her perspectives on payor practices and provider reimbursement are covered by the health care media and position clients ahead of new developments.

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Focus Areas

Experience

  • Negotiated, on behalf of a highly regarded academic medical center, long-term joint-venture agreements with New York State managed care organizations. Besides drafting insurance risk sharing, value-based payment contracts, Jackie advised the client on related federal and state health care and insurance laws and regulations.
  • Assists a fast-growing national clinical laboratory with all legal aspects of operationalizing its business, including state and federal regulatory issues, contracting with health plans and provider delivery systems and self-pay patients, compliance, privacy and security, and other matters.
  • Serves as outside counsel to a quickly growing national health company focused on opioid treatment. Jackie counsels on federal and state regulatory, compliance, managed care contracting, litigation, IP, privacy and security, and other matters. The company provides telebehavioral networks to national health plans for their commercial and governmental programs as well as self-pay individuals.
  • Negotiated, on behalf of a large health plan in the Northeast, long-term joint-venture agreements with a hospital system involving cobranded products and risk sharing contracts. Jackie advised the client on related federal and state health care and insurance laws and regulations.
  • Advises a large independent physician group in the Northeast on value-based reimbursement contracts with health plans and other payors, and related regulatory and dispute resolution matters.
  • Serves as outside counsel to the largest not-for-profit health system in the United States. Jackie has been advising this client on federal and state health care laws and contracts with managed care plans.
  • Helped create one of the nation’s first lab benefit management companies. Jackie represented the company in long-term value-based payment arrangements with national health plans to provide software, lab networks, and other services designed to improve the quality and control cost of lab tests. She also guided the client through contract and regulatory issues related to licensing innovative software delivering clinical, pricing, and benefit information to physicians at the point of care.
  • Serves as outside counsel to a fast-growing, national telebehavioral health company on federal and state regulatory, compliance, contracting, litigation, IP, privacy and security, and other matters. This client provides telebehavioral networks to national health plans for their commercial and governmental programs.

Recognition

  • The Legal 500 United States, Healthcare: Advice to Health Insurers (2016, 2018 to 2023)
  • The Best Lawyers in America©, Health Care Law (2015 to 2024)

Credentials

Education

  • Georgetown University Law Center (J.D., cum laude)
  • Pennsylvania State University (B.A., with highest distinction)

Bar Admissions

Media

Events

Insights

Insights

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