Ivette Sanchez joined Ropes & Gray's corporate department in 2017 and practices as part of the firm’s health care group. Ivette provides regulatory, transactional and compliance advice to a range of health care clients, including hospitals and health systems; universities and medical schools; managed care organizations; physician and provider networks; and health care focused private equity firms.
During law school, Ivette interned at VNS Health where she supported health care legal and compliance matters for the multiple entities in the VNS Health corporate family, including a licensed home care service agency, a certified home health agency, a hospice and managed care plans.
Experience
Managed Care Regulatory and Compliance. Counsel various managed care plans on government program contract requirements, including encounter data submission, enrollee communications, quality incentive methodologies, fraud and abuse reporting, marketing, and grievances and appeals. Draft compliance policies and procedures for Medicare Advantage plans and New York Medicaid Managed Care plans. Advise plans on sales and acquisition and necessary regulatory approvals. Performed compliance program assessment for client with New York Medicaid Managed Care plans and Medicare Advantage plans. Drafted strategic planning presentation for New York Medicaid Managed Care plan.
Management/Dental Services Organizations. Advise on mergers, acquisitions and affiliations for leading dental services organization in the United States, including cross-border management services arrangement with a dental services organization in Canada. Advise Florida-based management services organization entering New York and New Jersey on corporate practice of medicine, New York Medicaid enrollment, Anti-Kickback Statute, and beneficiary inducements.
Value-Based Payment. Provide value-based contracting advice to health care providers, population health management providers, and care management services provider negotiating in multiple states. Advise clients on applicability of state risk-bearing requirements and prepare and obtain regulatory certificates or waivers, as necessary.
Private Equity. Advised private equity clients on compliance and regulatory risks for affiliations with management services organizations, medical device manufacturers, home health and hospice providers, and managed care plans and their downstream contractors. Provide ongoing health care regulatory advice to portfolio companies including urgent care providers, behavioral health providers, management services organizations and care management providers.
Government Enforcement. Defend health care companies, including Medicare Advantage plans, home care providers, and New York Medicaid Managed Care plans, in federal and state enforcement actions related to the Anti-Kickback Statute and the False Claims Act.
Self-Disclosure/Audits. Advise New York health plans and providers on responding to audits by the New York Office of the Medicaid Inspector General. Prepare self-disclosures to New York Office of Medicaid Inspector General.
Reimbursement. Counsel New York hospital system on Medicare and New York fee-for-service Medicaid reimbursement and documentation requirements for telephone-only primary care services during the COVID-19 Public Health Emergency. Counsel New York hospital system on structuring value-based payment model authorized under federal waiver consistent with state reimbursement law. Counsel electronic health record vendors on structuring internal workflows for compliance with Medicare reimbursement requirements. Counsel kidney care provider on reimbursement and licensing considerations for in-home dialysis under federal and state law.
Pro Bono. Assist low-income New Yorkers with preparing tax returns as of the Food Bank for New York City’s Volunteer Income Tax Assistance program. Draft memorandum on compliance with requirements related to the provision of abortion services for recipients of federal funding (i.e., Medicaid, Title X and Section 330).