Sarah E. Swank

My focus

 Accountable Care Organizations (ACOs) 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 practices, joint venture models, medical faculty entities, Federally Qualified Health Centers, children’s hospitals, health information exchanges, long-term care facilities, and hospital-owned health plans.

Digital Health, Telehealth, Artificial Intelligence (AI)

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 the 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 Programs

My fraud and abuse background focuses on advice and guidance under Stark, Anti-Kickback Statute, Civil Monetary Penalties, and the False Claims Act related to telehealth, 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 Department of Justice (DOJ) on Stark and medical necessity, assisting with structuring physician arrangements and transactions, conducting internal investigations, and advising regarding CIA implementation post-settlement. In addition, I support compliance programs and HIPAA advice and investigations, including cybersecurity and data breaches.

Clinical Research and Institutional Review Boards (IRBs)

My work in the area of clinical research and institutional review boards (IRBs) includes due diligence reviews during hospital mergers, Food and Drug Administration (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.

Health Equity

I provide health equity thought leadership and supports healthcare providers, technology companies, and associations navigating the complex and changing legal and health policy framework around health equity.  I work in cross-disciplinary teams to ensure compliance with access and safety requirements, data use and reporting, clinical research, fraud and abuse, and other federal and state requirements related to access and health equity.  I helpclients in compliance and innovation around health equity as it becomes a measurable standard tied to payment reform, social determinants of health (SDOH), and population health activities. These standards are found in policies and procedures, governance activities monitoring, workforce initiatives, and other compliance and operational activities. Health equity is not done with one training program, but through ongoing commitment, advising and change.  Health equity goes beyond access to healthcare and insurance to ensure that communities have the right to a healthy life and life expectancy.

Looking ahead

 Virtual care models will be integrated into care delivery with a focus on health equity and data use including AI, wearables and remote patient monitoring. As we move toward value-based care, care coordination, and digital health solutions, my historic perspective, real-world operational knowledge and practical solutions provide valuable insight into where the healthcare industry and health policy are heading and how stay nimble in a changing regulatory environment.

Insights

Sarah Swank is a national speaker, author, and thought leader in supporting organizations to navigate the rapid changes occurring in healthcare, 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, Digital Health, and Cybersecurity

• Panelist, “Digital Equity and Healthcare Law,” Federal Communications Law Journal's Barriers to Digital Equity Symposium, Washington DC, April 7, 2023
• Presenter, “Cybersecurity in Healthcare: Leveraging Insurance, Recent Government Guidance, Mitigating Risk,” Strafford CLE Webinar, November 22, 2022
• Presenter, “Digital Equity Beyond Demographics,” NH Telehealth Alliance's 2022 Public Policy Summit, Webinar, November 17, 2022
• Moderator, “Health Equity and Telehealth: Going from Barriers to Belonging,” ATA2022 Annual Conference & Expo, Boston, MA, May 1, 2022
• Presenter, “Remote Patient Monitoring: Health Policy, Legal Pitfalls, and Reimbursement Reform,” BRI Network's 2022 Remote Patient Monitoring Summit,  Las Vegas, NV, January 31, 2022
• Presenter, “AI and Research: Trends to Tackle Bias, Data and Compliance when Using Artificial Intelligence in Clinical Research,” HCCA’s 2021 Research Compliance Conference, June 16, 2021
• Presenter, “The Digital Imperative – Marketing Disruption as A Path Forward After the Pandemic,” AHLA Virtual Health Care Transactions Program, April 16, 2021
• Presenter, “Preparing for the Digital Health Exposition,” American Health Law Association’s General Counsel Webinar Series Part I, April 13, 2021
• Presenter, “The Digital Imperative – Accelerating Hospitals and Physicians on Path Forward After the Pandemic,” AHLA's Virtual Physicians and Hospitals Law Institute Webinar, February 11, 2021
• Presenter, “Telemedicine Beyond COVID19: Provider Experiences and Future Challenges,” Nixon Peabody Webinar, June 25, 2020
• Presenter, “Artificial Intelligence and Healthcare: The Intersection of Science and Law,” American University College of Law Webinar, July 8, 2020
• Presenter, “AI and Telehealth: What You Need to Know Now,” American Telemed, June 22, 2020
• Presenter, “AI in Healthcare: Its Impact and What You Need to Know to Stay Compliant,” Healthcare Compliance Association Webinar, May 18, 2020
• Presenter, “AI and Telehealth: What You Need to Know Now,” ATA2020 Annual Conference & Expo, Phoenix, AZ, May 4, 2020
• Presenter, "Commercial Payer: Telehealth Reimbursement During COVID-19," CTeL Coronavirus Webinar Series, April 30, 2020
• Presenter, “COVID-19 and Telehealth,” American Health Lawyers Association Podcast, March 26, 2020
• Presenter, “Telehealth Trends: Risks, Rewards and Reimbursement,” Health Care Compliance Association, Webinar, March 23, 2020
• Author, “Bring home the bacon—Nutritionists as healthcare market disruptors,” Nixon Peabody Food & Beverage Crystal Ball, January 2020
• Presenter, “The Impact of AI on Healthcare: What You Need to Know,” Nixon Peabody Webinar, December 3, 2019
• 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 healthcare 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, “Vaccinating the Nation: What you Need to Know” Webinar, Head Start & COVID-19: A Symposium on Vaccination and Community Mitigation Efforts, February 8, 2021
• 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

• Presenter, “New ACO REACH Model: ACO Realizing Equity, Access, and Community Health Model, Navigating the Transition, Ensuring Compliance,” Strafford CLE Webinar, June 1, 2022
• Presenter, “New ACO Realizing Equity, Access, and Community Health Model: Navigating the Transition, Ensuring Compliance,” Strafford CLE Webinar, June 1, 2022
• Presenter, “Closing Value Based Care Gaps: Integrating Population Health and Specialty Care,” The Society for Health Care Risk Management of New Jersey, Webinar, January 21, 2022
• Presenter, “Vaccinating the Nation: What you Need to Know,” Head Start & COVID-19: A Symposium on Vaccination and Community Mitigation Efforts, February 8, 2021
• Presenter, “Buy, Build or Invest—A Wanna Be Distruptor's Guide to the New Health Care Models,” AHLA Health Care Transactions Conference, Nashville, TN, April 21, 2020
• 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 Healthcare 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

• Presenter, “Final Changes to Stark Law and Anti-Kickback Statute Regulations: What Your Organization Needs to Know,” Nixon Peabody LLP, Webinar, January 6, 2021
• Speaker, “Medicare Physician Fee Schedule: Preparing for E/M Changes and the Unintended Consequences,” American Bar Association, Webinar, December 15, 2020
• Speaker, “Navigating Insurance, Licensing, and HIPAA Regulations During the COVID-19 Crisis,” Inside Reproductive Health Podcast, Fertility Bridge, March 19, 2020
• 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

• Presenter, “Legal Ethics: When Boards are not Boring - What to Do When a Client Puts the Attorney in the Middle,” AHLA's Physicians and Hospitals Law Institute 2022, New Orleans, LA, February 3, 2022
• Moderator, “Wearables & Holistic Health Outcomes,” Women's Health Innovation Series Reproductive Health Innovation Summit, Boston, MA, February 15, 2022
• 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

• Speaker, “Legal Ethical Challenges for the Health Lawyer Regarding Unique Financial Arrangements with Clients,” AHLA's Physicians and Hospitals Law Institute 2023, Orlando, FL, January 31, 2023 & February 1, 2023
• Speaker, “Legal Ethics: Conflicts of Interest Policies - What to Do When A Client Conflict Turns Into An Attorney Headache,” AHLA's In-House Counsel Program, June 17, 2021
• “How Physicians Can Help Patients in Recovery from Substance Use Disorders During the COVID-19 Pandemic,” Health eSource, American Bar Association, July 2020
• Author, “The CARES Act: Funding and Other Key Considerations Impacting the Business of Non-Hospital Health Care Providers and Employers Operating Small Business,” Journal of Bankruptcy Law, June 2020
• Author, “The CARES Act: Assistance and Funding for Health Care Providers,” Journal of Bankruptcy Law, June 2020
• Speaker, “CARES Act for Healthcare Providers,” Strafford Webinar, May 12, 2020
• Speaker, “COVID-19 GC Roundtable, Part 3,” American Health Law Association’s Speaking of Health Law Podcast, April 22, 2020
• Speaker, “COVID-19 GC Roundtable, Part 2,” American Health Law Association’s Speaking of Health Law Podcast, April 13, 2020
• Speaker, “COVID-19 GC Roundtable, Part 1,” American Health Law Association’s Speaking of Health Law Podcast, April 1, 2020
• Author, “FAQs on Section 1135 Waivers: What Health Care Providers Should Know,” American Health Lawyers Association Publication, March 2020
• Presenter, “EMTALA and COVID-19,” American Health Lawyers Association Podcast, March 23, 2020, , 
• Presenter, “How to Prepare for and Respond to the Impacts of COVID-19,” Health Care Compliance Association Webinar, March 26, 2020
• Presenter, “COVID-19: The Latest Updates and Guidance for Hospitals and Health Care Entities,” Nixon Peabody Webinar, March 25, 2020
• Presenter, “COVID-19 Update—Health Care: Essential steps for hospitals and health care entities to prepare and respond now,” Nixon Peabody Webinar, March 10, 2020
• Co-Author, “Responding to COVID-19–8 Steps for Hospitals to Protect Patients, Employees, and Communities,” American Health Lawyers Association Publication, March 2020
• Presenter, “2019 Novel Corona Virus: Legal Preparedness for the Healthcare Sector,” CDC’s Public Health Law Program and American Health Lawyers Association Webinar, 2020
• Presenter, “When Violence Comes Calling: Approaches to Today’s Common (and Unfortunate) Violence,” AHLA Physicians and Hospitals Law Institute, Phoenix, AZ, 2020
• 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