Sarah E. Swank

What do you focus on?

Accountable Care Organizations, Clinical Integration, and Managed Care

I provide strategic advice to executive leadership at health systems, hospitals, academic medical centers, long-term care, and large physician organizations. I advise clients regarding accountable care organizations (ACOs) and clinically integrated networks through all stages of development, including application into the Medicare Shared Savings Program. I assist with innovative approaches to pay-for-performance, managed care contracting, care coordination, and population health. My experience includes ACOs with multiple hospital systems, physician-owned, joint venture models, medical faculty entities, Federally Qualified Health Centers, children’s hospitals, health information exchanges, long-term care, and hospital-owned health plans.

Digital Health, Telehealth, Artificial Intelligence, and HIPAA

I counsel major academic medical centers, nationally recognized health systems, and ACOs in launching and growing complex operational programs, such as national and international telehealth, digital health, and AI programs. I work directly with in-house counsel and senior and clinical leadership on strategic development and implementation of telehealth and e-health programs. Additionally, I assist technology startups with regulatory and corporate advice, including HIPAA compliance. I recently assisted an internationally known academic medical center with planning, implementation, and advice regarding telemedicine credentialing, governance, operational, HIPAA, and fraud and abuse matters. My background includes advising academic medical centers on international second opinion programs and strategic planning regarding programmatic international expansion. I have firsthand experience managing these issues as in-house counsel.

Fraud and Abuse and Compliance

My fraud and abuse background focuses on advice and guidance under Stark, the Anti-Kickback Statute, Civil Monetary Penalties, and the False Claims Act related to physician transactions, compliance programs, graduate medical education, clinical research, medical director and other physician arrangements, investigations, and compliance efforts after a corporate integrity agreement (CIA). I integrate operational issues with technical analysis of the fraud and abuse laws to suggest practical solutions. My experience includes acting as fraud and abuse counsel during negotiations with the DOJ on Stark and medical necessity, assisting with structuring physician arrangements and transactions, conducting internal investigations, and advising regarding CIA implementation post-settlement.

Clinical Research and IRBs

My work in the area of clinical research and institutional review boards (IRBs) includes due diligence reviews during hospital mergers, FDA audits, reporting, program evaluation, and compliance of IRB and research programs for academic medical centers and community hospitals. I successfully prepare and advise clients during FDA audits, assist with the integration of research activities into compliance programs and electronic health records and digital implementation, perform HIPAA compliance assessments, and provide training and education to IRBs.

What do you see on the horizon?

I understand the pressures of general counsel who face increased budgetary demands and the need to adapt to changes in the health care industry. As we move toward pay-for-performance arrangements, care coordination, and digital health solutions, my prior experiences provide valuable insight into where the health care industry is heading both nationally and internationally.

Publications and Presentations

Sarah Swank is a national speaker, author, and thought leader in supporting organizations to navigate the rapid changes occurring in health care, including payment reform, ACOs, telehealth, and artificial intelligence. Sarah continues to be an innovator in the health care arena, having presented and authored on various topics, including serving as the first speaker at both HIMSS and the American Telemedicine Association on ACOs as well as the first professional to speak on telehealth issues with the American Health Lawyer Association. A selection of her standout presentations and publications over the years include the following:

AI, Telehealth and Digital

• Author, “Bring home the bacon—Nutritionists as health care market disruptors,” Nixon Peabody Food & Beverage Crystal Ball, January 2020
• Panelist, “Telehealth Trends: Risks, Rewards and Reimbursement,” Nixon Peabody Webinar, November 14, 2019
• Panelist, “Artificial intelligence and the legal implications, safety considerations and opportunities for utilizing AI and telehealth in the health care industry,” Illinois Telehealth Law & Policy Forum, 2019
• Presenter, “What’s Next for ACOs - Managing Financial Risk and Measuring Quality Through Telehealth,” American Telemedicine Association, 2014
• Presenter, “Developments and Trends in Telemedicine,” Alabama Health Law Section, Cumberland School of Law at Samford University, 2014
• Presenter, “The Nuts and Bolts of Launching and Growing a Telemedicine Program,” Physicians and Hospitals Law Institute, American Health Lawyers Association, 2014
• Presenter and Moderator, “The Technology of Telemedicine,” Telehealth Bootcamp Series: A Look at Legal and Regulatory Matters Specific to Telehealth, Telemedicine and m-Health, American Health Lawyers Association, 2014
• Presenter, “The Nuts and Bolts of Launching and Growing a Compliant Telemedicine Program,” Webinar, Health Care Compliance Association, 2013
• Presenter, “The Future of Telemedicine: Paving the Road Ahead and Making the Case for Telehealth,” Telehealth Bootcamp Series: A Look at Legal and Regulatory Matters Specific to Telehealth, Telemedicine and m-Health, American Health Lawyers Association, 2013
• Presenter, “ACOs and Integration: What is on Horizon for Telemedicine,” ATA Annual International Meeting & Trade Show, American Telemedicine Association, 2013
• Presenter, “CMS Telemedicine Credentialing & Privileging: Legal Do’s & Don’ts,” Webinar, Progressive Healthcare Conferences, 2012
• Presenter, “Telemedicine Credentialing and Privileging: Complying with the New CMS Rule,” Webinar, Strafford Publications, 2011
• Presenter, “Successfully Meeting the Legal and Financial Challenges of EHR Implementation,” Healthcare Law & Compliance Institute, International Performance Management Institute, 2011

ACOs, Value-Based Care and Managed Care

• Panelist, “ACOs: The Year in Review—Hot Topics, Developments of the Past Year, and Prognostications for the Future,” Healthcare Transactions Program, American Health Lawyers Association, 2014
• Presenter, “Accountable Care Organizations and Provider Integration Under Health Care Reform,” National Business Institute, 2014
• Presenter, “ACO Formation, Operation and Compliance,” 2014 Compliance Institute, Health Care Compliance Association, 2014
• Presenter, “ACOs and the Affordable Care Act,” Video Broadcast, Federal Bar Association, 2013
• Presenter, “The Marketplace is Now Open for Business: What you Need to Know About the Health Insurance Exchange,” Webinar, Health Care Compliance Association, 2013
• Presenter, “ACOs and What a Compliance Officer Should Know,” Corporate Compliance Forum, The Children’s Hospital Association, 2013  
• Author, “Quality-Based Healthcare Models: Getting More Bang for Your Healthcare Buck,” AHLA Connections, American Health Lawyers Association, 2013
• Presenter, “Insurance Exchanges: How They Work, What They Change,” Webinar, National Business Institute, 2013
• Presenter, “Supreme Court Affordable Care Act Decision: What’s Next for Health Care Providers?” Practicing Law Institute, 2012
• Presenter, “EHRs and ACOs: You Can’t Have One Without the Other,” HIMSS Annual Conference and Exhibition, 2012
• Author, “Five Trends in Health Care for Election Year 2012,” Health Law Report, Bloomberg Law Reports, 2011
• Author, “Will ‘Qualified Entities’ Be up for the Quality Public Reporting Challenge?” AHLA Connections, American Health Lawyers Association, 2011
• Presenter, “The Final ACO Regulations: Is Participation Worth a Second Look?” Webinar, American Bar Association Health Law Section and the ABA Center for Continuing Legal Education, 2011
• Panelist, “New Directions for Healthcare Delivery - Leadership Perspective,” Healthcare Conference, BB&T Capital Markets, 2011
• Panelist, Second Annual Health Care Real Estate Summit, BISNOW, 2011
• Presenter, “Health Care Reform: A Year Later - HIPAA and HITECH, ACOs and Enforcement Tools,” Health Care 2011, Practicing Law Institute, 2011

Stark, Anti-Kickback, HIPAA and Compliance

• Co-author, “AHLA Health Care Compliance Legal Issues Manual,” American Health Lawyers Association, 2019
• Presenter, “Hot Topics in EMTALA: Screening and Triaging Emergency Room Challenges,” Physicians and Hospitals Law Institute, American Health Lawyers Association, 2018
• Chapter author, “Enforcement under HIPAA and HITECH: Why You Need to Worry Again About HIPAA,” Health Care IT: The Essential Lawyer’s Guide to Health Care Information Technology and the Law, Section of Science and Technology Law, American Bar Association, 2013

Clinical Research, Innovation and Institutional Review Boards

• Co-author, “Institutional Review Boards: A Primer,” Third Edition, American Health Lawyers Association, 2018
• Presenter, “The Brave New World of Research Regulations: What You and Your IRB Need to Know Now,” Global Conference, Association of Clinical Research Professionals, 2014
• Author, “Research Records and EHRs: Five Practical Tips in a New Compliance Era,” Compliance Today, 2012
• Author, “Is Your Research Data Safe? HHS Seeks to Strengthen Protections Under the Common Rule,” HIT News, American Health Lawyers Association, 2012

The General Counsel and Legal Department Best Practices

• Author, “Health Care Under Fire—Preparing for an Active Shooter Before Your Facility Is a Target,” American Health Lawyers Association, 2019
• Moderator, “The General Counsel Series Part III: Legal Department Management,” American Health Lawyers Association Webinar, 2019
• Moderator, “The General Counsel Series Part II: Contract Management,” American Health Lawyers Associate Webinar, 2019
• Co-author, “The Future of In-House Counsel: Five Reasons Why the Practice of Health Law is Changing,” AHLA Connections, 2015