• Drafting and negotiation of contracts on the national, state and local levels for hospitals, provider networks, and managed care organizations
• Organization of a regional physician-hospital network that is today comprised of 45 hospitals and approximately 2,000 physicians and negotiation of more than 60 managed care contracts on their behalf
• Development of numerous managed care healthcare provider networks, including creation of approved non-profit health corporations under the Texas Occupations Code, physician-hospital networks, and independent practice associations
• Asset sale of major hospital system that involved the transfer of the membership interest in a managed care limited liability company to a non-profit holding company pending transfer to a newly-created non-profit hospital system

Regulatory matters

• Representation of publicly-traded company in applying for Certificate of Authority as a Texas HMO and participation in the managed Medicaid and CHIP programs
• Representation of plans, providers, and drug manufacturers before the Texas Department of Insurance, Texas Health and Human Services Commission, and Texas Attorney General
• Presentation of legal analyses to CMS for clarification on issues related to the Medicare Advantage program
• Representation of Texas university’s medical branch and non-profit health care system on complex constitutional issues related to the use of public funds for a private purpose in connection with the creation of a joint venture arrangement for participation in the STAR and STAR+PLUS managed Medicaid programs in Harris County
• Representation of managed care organizations in applications for certificates of authority as Texas HMOs to arrange for healthcare services under the STAR and STAR+PLUS managed Medicaid programs in Harris County and the Medicare+Choice program
• Structuring of a two-stage ownership transfer arrangement between two large hospital systems that resulted in changes and consolidation of ownership interests in HMOs affiliated with the hospital systems and that required approval from the Texas Department of Insurance
• Change of ownership of three major HMOs that required approval from the Insurance regulators in three states and applications for third party administrator and utilization review agents licenses
• Representation of managed care entities under supervision, conservatorship, and/or receivership by the Texas Department of Insurance
• Representation of an academic medical center consisting of 9 academic institutions, 6 health institutions, 4 medical schools, 2 dental schools, and 7 nursing schools in developing a HIPAA compliance program
• Representation of an integrated delivery system consisting of 14 hospitals and 31 clinics in development of a HIPAA compliance program
• Representation of chain pharmacy in developing a HIPAA assessment and organizational analysis

Legislative and rulemaking matters

• Representation of hospitals and carriers on workers' compensation reform legislation and rulemaking
• Representation of hospitals on specialty hospital legislation
• Representation of Texas healthcare providers, health plans, academic medical centers, and major employers in connection with state health information privacy initiatives
• Representation of a hospital district and children’s hospital in connection with preparing comments and testimony on privacy rules
• Representation of Texas health plans seeking veto of Texas Senate Bill No. 1468 regarding physician joint negotiations
• Participation as invited stakeholder in development of Texas Attorney General implementation procedures governing physician joint negotiations under Chapter 29 of the Insurance Code enacted by the 1999 Texas Legislature
• Appointment by the Commissioner of Insurance in 1998 to the Texas Department of Insurance Financial Incentives Task Force to study and make recommendations regarding guidelines for financial incentive arrangements between managed care entities and physicians and physician groups
• Monitoring, providing invited testimony and client advocacy in both state legislative and rulemaking initiatives
• Advice to health plans and healthcare providers on the impact of healthcare legislation and regulations in Texas

• Member: American Health Lawyers Association; Health Law Section, State Bar of Texas
• Recipient: Philip R. Overton Lectureship in Medicine and the Law, Texas Medical Association, September 1997
• Editor: Vinson & Elkins, HealthWatch, 2000-2001
• Executive Editor: “The 77th Texas Legislature Mid-Session Report,” April 2001
• Issues Editor and Author: “The Mega Reg,” Vinson & Elkins Legal Update, Healthcare Alert, September 1998
• Author: “Managed Care Integrity in Risk Arrangements,” in the Managed Care Law Strategist, August 2001; “Commentary: A Defensive Use of the Physician Incentive Plan Rules,” AHLA Physician Organizations Newsletter, April 1998; “The Million-Dollar Question: Where Does the Buck Stop in Managed Care Liability Claims?,” On Managed Care (Vol. 2, No. 10), October 1997; Chapter entitled “Risk Contracting” in the Texas Medical Association’s The Law of Managed Care Home Study Program for continuing medical education
• Co-Author: “The ‘Texas Two-Step’ Towards Cleaning Up & Clearing Up Claims Payment and Delegated Networks’ Responsibilities,” Healthcare Financial Management Association’s Gulf Coast Lines, August/September 2002; “Putting the “Choice” into the Medicare+Choice Program,” Managed Care Law Strategist, May 2000; “Defining Managed Care Liability,” Texas Lawyer, April 3, 2000; “Splitting the Baby? A Houston Federal Court’s Gloss on Managed Care May Have Killed Most of the Texas Legislature’s Landmark Reforms,” Texas Lawyer, November 30, 1998
• 2005 Speaking Engagements:  “Managed Care 2005: New Products, New Challenges,” World Research Group, Boston, Massachusetts, November 2005; “State and Federal Legislative Update: Focus on Workers’ Comp, Managed Medicaid and Patient Safety,” State Bar Health Law Conference, October 2005; “Medicare Advantage: The Plan/Provider Dance,” Texas Association of Health Plans Annual Conference, San Antonio, Texas, September 2005; “Texas Legislative Update:  Network Development and New Integrated Care Management and Workers’ Compensation Models,”  Legislative Symposium, Austin, Texas, July  2005; “Managed Care Strategies: Building a Provider Network,” Lubbock, Texas, June 2005; “Critical Issues in Health Research,” Bio Texas Summit ²05, Austin, Texas, June 2005; “Texas Legal Update,” Longview, Texas, May 2005; “Managed Care 2005:  Products, Politics and Privatization,”  17th Annual Health Law Conference, Houston, Texas, April 2005
• 2004 Speaking Engagements:  “Managed Care Solutions:  Revenue, Recovery, Revenue Enhancement and Network Development Opportunities,” BKD Advanced Reimbursement Conference, Kansas City, Missouri, December 2004; “Medicare Advantage from the Hospital’s Vantage,” Austin, Texas, August 2004, and Houston, Texas, February 2004; ”Discounts for the Uninsured:  The #1 Issue Currently Facing Hospitals,” V&E; client seminar, August 2004; “United States Regulations and Reimbursement of Drugs and Medical Devices,” International Pharmaceutical Industry, Stockholm, Sweden, May 2004; “The Providers’ Prompt Pay Action Plan,” Houston, Texas, April 2004
• 2003 Speaking Engagements: “The 78th Was a Very Special Session” Travis County Bar Association Health Law Meeting, Austin, Texas, October 2003; “All Eyes on Texas,” Privacy Compliance for Pharmaceutical Marketing, Sales & Commercial Operations Conference, Philadelphia, Pennsylvania, September 2003; Panelist, “Privacy Panel,” University of Texas’ Third Annual U.T. System Legal Conference, Austin, Texas, September 2003; “If You’ve Got the Money, I’ve Got the Time: Prompt Pay and other Reimbursement Issues” and “No More ‘Wide Open Spaces’: Access to Health Care Information; Health Facilities Regulation,” Vinson & Elkins ‘ Fourth Biennial Symposium on Health Care Legislation, Austin, Texas, July 2003
• 2002 Speaking Engagements: Panelist, “Prompt Pay, Managed Care, Tort Reform, Scope of Practice, Centralized Credentialing, and Other Medical Issues Facing the Legislature,” Greater Houston Anesthesiology Legislative Dinner, Houston, Texas, September 2002; “Final HIPAA Modifications,”  University of Texas Second Annual U.T. System Legal Conference, Austin, Texas, September 2002; “Privacy and Texas (S.B.11) HIPAA,”  Texas Healthcare & Bioscience Institute Summer Meeting, Austin, Texas, August 2002; “S.B.11 – The New Texas Privacy Standards: Analysis, Answers, and Action Items (for Now),” Texas Society of CPAs’ Health Care Conference, San Antonio, Texas, July 2002; “Implementing HIPAA and State Privacy: Moving to Compliance,” Texas Hospital Association Conference and Expo, Houston, Texas, June 2002; “S.B.11: The New Texas Privacy Standards-Analysis, Answers & Action Items (for Now) and Impact of HIPAA on Academic Medical Centers and Research,” Vinson & Elkins’ Symposium and Roundtable Discussions, Houston, Texas, March 2002; “HIPAA for the Academic Medical Center,” American Health Lawyers Conference on Legal Issues Affecting Academic Medical Centers and Other Teaching Institutions, Washington, D.C., January 2002
• 2001 Speaking Engagements: “Are You Attached at the HIP(AA),” Texas Hospital Association’s The Anatomy of Managed Care Seminar, Austin, Texas, November 2001; ”HIPAA Basics and Beyond with Specific Implementation Recommendations,” Health Law Section of the State Bar of Texas and Texas Hospital Association Texas 2001 Health Law Conference, Austin, Texas, October 2001; “‘Bidness’ Confidential: Health Information Privacy,” Vinson & Elkins’ Third Biennial Symposium on Health Care Legislation, Austin, Texas, July 2001; “The State of Managed Care” University of Texas 13th Annual Health Law Conference, Houston, Texas, April 2001
• 2000 Speaking Engagements: “Are You Attached at the HIP(AA)?,” Texas Hospital Association The Anatomy of Managed Care Seminar, Austin, Texas, November 2001; “HIPAA Basics and Beyond with Specific Implementation Recommendations,” Health Law Section of the State Bar of Texas and Texas Hospital Association 2001 Health Law Conference, Austin, Texas, October 2001; “‘Bidness’ Confidential:  Health Information Privacy,” Vinson & Elkins’ Third Biennial Symposium on Health Care Legislation, Austin, Texas, July 2001; “The State of Managed Care,” University of Texas 13th Annual Health Law Conference, Houston, Texas, April 2001
• 1999 Speaking Engagements: “Managed Care Reform and Its Impact on Operations,” American Health Lawyers Association Managed Care Law Institute, Chicago, Illinois December 1999; “Physician Collective Bargaining and Delegated Networks,”  Texas Association of Health Care Financial Administration and Health Care Financial Management Association for Region IX Joint Fall Symposium 2000 Questions, 1999 Answers, Dallas, Texas, October 1999; “The Legislative Assault: Changing the Way We Do Business,” National IPA Coalition Annual From Vision to Action: Leadership Strategies and Operations, San Antonio, Texas, October 1999; “Legislation Affecting IPAs,” Texas IPA Association, Houston, Texas and Dallas, Texas, September 1999; Moderator of Managed Care/Insurance and Physician Collective Bargaining Panels, Second Biennial Symposium on Health Care, Austin, Texas, July 1999; “The 76th Texas Legislature:  Managed Care, Physician, and Medicaid Initiatives,” Texas 5.01(a) Alliance, Dallas, Texas, June 1999; Legislative Session Update, Spohn Health System, Corpus Christi, Texas, April 1999; “Risk Management Strategies to Respond to Emerging Trends in Managed Care Liability,” American Health Lawyers Association Managed Care Law Institute, Chicago, Illinois, December 1998, and Louisiana Chapter of the Health Care Financial Management Association, Baton Rouge, Louisiana, January 1999; “The Medicare+Choice Program,” Louisiana Hospital Association and Ohio Hospital Association, August 1998, and Louisiana Chapter of the Health Care Financial Management Association, Baton Rouge, Louisiana, January 1999
• 1997 - 1998 Speaking Engagements: “Liability Issues in Managed Care,” Statewide Risk Managers Annual Meeting, February 1998; “Ethical Dilemmas in Managed Care: Cost Versus Care,” Continuing Medical Education, Committee of Sierra Medical Center, El Paso, Texas, February 1998; “Emerging Theories of Managed Care Liability,” Texas Gulf Coast Association for Healthcare Quality, Houston, Texas, November 1997, Catholic Health Association’s 83rd Catholic Health Assembly, New Orleans, Louisiana, June 1998, Spohn Health System, Corpus Christi, Texas, June 1998, and The Texas Association of Municipal Health Officials  in cooperation with Health Delivery Systems, L.L.C., Austin, Texas, March 1998; “Managing Physician Risks in Managed Care Contracts,” Texas Medical Association 1997 Fall Leadership Conference, Austin, Texas, September 1997; “Shifting, Shielding and Spreading Managed Care Liability Through Contract,” The University of Texas School of Law Managed Care Litigation Conference, Austin, Texas, September 1997, and Greater Houston Society for Healthcare Risk Management, Houston, Texas, February 1998; “1997 Legislative Series SB 386:  Reading Between the (Base) Lines,” Austin, Texas, June 1997; “Managed Care and the Big Debate: Cost vs. Care,” Houston Chapter – Texas Society of Certified Public Accountants, Houston TSCPA Foundation, Houston, Texas, June 1997; “Facing Capitationphobia:  A Legal Perspective,” American Health Lawyers Association Annual Meeting, Dallas, Texas, June 1997; “75th Texas Legislature: Update on Physician and Managed Care Initiatives with Focus on SB 386,” Conference on Statewide Organization of Anesthesia Practices, Houston, Texas, April 1997

• The University of Texas, B.A. with high honors in English and Spanish, 1978
• The University of Texas School of Law, J.D. with honors, 1990 (Phi Beta Kappa)
• Legal intern for Judge Nathan Hecht of the Supreme Court of Texas
• Admitted to practice: Texas, 1990