Susan Ingargiola

Susan Ingargiola is an associate in the Corporate Practice Group in the firm's New York office and a member of the healthcare team. 

Areas of Practice

Susan advises healthcare organizations on business, regulatory and transactional matters. Her clients include hospitals, health systems, physician practices, insurers, community health centers, health information exchange organizations, management companies, pharmaceutical and biotechnology companies, and mobile app developers.

Susan provides counsel on issues relating to corporate formation, governance, transactions (mergers, joint ventures, asset sales, dissolutions), federal, state and local tax exemption, fraud and abuse, the 340B drug discount program, Medicare/Medicaid reimbursement, the corporate practice of medicine, health information privacy, including compliance with HIPAA and state medical record confidentiality laws as well as more recent “information blocking” regulations, and other compliance-related matters. 

Susan also regularly assists health care provider and payer clients with navigating the complex issues surrounding CMS innovation models such as the Medicare Shared Savings Program, the NextGen ACO Model, and the Direct Contracting Model and as well as commercial value based reimbursement initiatives. Her practice in this area extends to drafting contracts that incorporate the many complex regulatory requirements imposed by CMS on health plans, ACOs, IPAs and their downstream contractors.  Susan’s payer clients offer products in the Medicare Advantage program and on the ACA’s Marketplace and her counsel covers the regulatory compliance obligations attendant to participation in these markets.

Susan began her career as an intern in the Clinton White House. She has also worked in both houses of Congress and was part of the government relations department at pharmaceutical giant, Merck & Co., Inc. Prior to joining Sheppard Mullin, Susan practiced healthcare law and consulting at another national law firm.

Articles

Healthcare Law Blog Posts

• "Analysis of OIG’s New and Revised Regulatory Safe Harbors to the Federal Health Care Program Anti-Kickback Statute and Beneficiary Inducement Prohibition." December 22, 2020

• "Critical Analysis and Practical Implications of CMS’ Changes to the Stark Law’s Implementing Regulations," December 11, 2020

• "Office of the National Coordinator for Health IT Extends Compliance Deadlines under Interoperability Final Rule," November 6, 2020

• "HHS OIG Issues Report Critical of Medicare Advantage Risk Adjustment Practices," September 24, 2020

• "HHS Further Relaxes HIPAA Regulations Governing Use and Disclosure of Protected Health Information During the COVID-19 Public Health Emergency,"  April 14, 2020
• "CMS Releases Interoperability Rule Designed to Increase Patient Access to Health Information," March 31, 2020

• "Legislation Re-Introduced to Expand Access to Telehealth Under Medicare," November 7, 2019 
• "California Expands Medicaid Telehealth Policy," October 7, 2019 
• "OIG to Audit Provision of Behavioral Health Services Through Tele-Health Under Medicaid Managed Care," October 4, 2019
• "Is Prescription Drug Pricing The Cure For Partisanship?" July 25, 2019
• "CMS Expands Telehealth Benefits under Medicare Advantage," April 10, 2019 

Events

Digital Media