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.
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
- New York
Professional & Community Involvement
- Heart of Passion, Board Member
Media
Events
Insights
Insights
- Media CoverageMarjorie Scher Quoted in “Citing U.S. Supreme Court Decision, Health System Sues Medicare Advantage Plan for Past 340B ...4 minute read
- PublicationsNew Coverage, Delivery, and Payment for Health-Related Social Needs Services Under New York’s Approved 1115 Medicaid ...13 minute read
- BlogsAn Overview of the CMS Approved New York 1115 Medicaid Waiver12 minute read
- PublicationsHospital and MA Plan Considerations for CMS Final Rule to Remedy 340B Drug Payment Policy11 minute read
- BlogsCMS Adds Place of Service to Allow Additional Flexibility in Delivering Medicare and Medicaid Healthcare Services to the ...7 minute read
- BlogsNavigating the New New York Department of Health Regulation on Facility Fees9 minute read
- Firm Announcements
Epstein Becker Green Attorneys Recognized by 2024 Best Lawyers for Excellence in the Legal Profession
12 minute read - BlogsCMS Forwards Its Health Equity Agenda Through Its Annual Prospective Payment System Rulemaking Process5 minute read
- BlogsThe Joint Commission’s 2023 Focus on Health Equity4 minute read
- Publications2023 Physician Fee Schedule Final Rule Supports Health Equity Through Investments in Accountable Care Organizations ...12 minute read
- Publications
In Wake of Dobbs Decision, CMS Issues Guidance to Hospitals on EMTALA Obligations
12 minute read