Overview

Managed care organizations and health care providers know they can rely on attorney Marjorie Scher for help on managed care contracts and regulatory matters, including Medicare and Medicaid compliance, value-based payment methodologies, and corporate practice of medicine.

Marjorie understands the complexities of the network arrangements in the managed care space, including in- and out-of-network reimbursement and intermediary carve-out service arrangements for services such as behavioral health and disease management.

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At her previous firm, Marjorie founded a research and policy team at the outset of the COVID-19 pandemic that analyzed the immense amount of new legislation and regulation affecting the Medicaid space.

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Focus Areas

Experience

  • Drafted managed care participation and care coordination agreements for various providers such as physicians, facilities and ancillary providers.
  • Created a new model managed care contract for a state client after the client expressed concern that its existing contract did not comply with CMS requirements. Marjorie and her team’s new model contract complied with CMS requirements as well as the state's mental health parity, network adequacy, and alternative payment models goals. CMS intends to use the model contract as a best practice example in its Criteria for Medicaid Managed Care Contract Review and Approval.
  • Researched case law and statute to draft a two-part expert witness rebuttal defending a state client against claims of unnecessary institutionalization and an inadequate long-term care plan under, among other things, the Americans with Disabilities Act.
  • Advised a federally qualified health center on the impact of separation from its parent system, including considerations of CMS Conditions of Participation and Certificate of Need requirements associated with re-licensure.
  • Reviewed a master service agreement between a prison health care provider and a state Department of Corrections for a private equity firm’s investment in the former.

Recognition

  • The Best Lawyers in America©: “Ones to Watch” in Health Care Law (2024)

Credentials

Education

  • Tulane University School of Law (J.D., 2015)
    • Senior Articles Editor, The Sports Lawyers Journal
    • H. Martin Hunley, Jr. Award in Health Care Law
  • Tulane University School of Public Health and Tropical Medicine (M.H.A., 2015)
    • Upsilon Phi Delta Honor Society
  • Binghamton University, State University of New York (B.A., 2011)

Bar Admissions

Professional & Community Involvement

  • Heart of Passion, Board Member

Media

Events

Insights

Insights

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