Claire E.Castles

Partner

Los Angeles + 1.213.243.2629

Claire Castles advises clients on complex health care and life science regulatory compliance issues in transactions, investigations, and litigation matters, including issues that are international in scope, relate to significant regulatory enforcement, and present potential reputational concerns.

Claire assists clients in implementing proactive and strategic practices that promote regulatory compliance related to Medicare and Medicaid reimbursement and compliance issues, provider-based status, site-neutrality payment reform, graduate medical education programs and reimbursement, clinical trial reimbursement, 340B and Medicaid Drug Rebate programs, drug and device coverage and reimbursement, and physician alignment strategies. She also advises clients on state and federal health payment reform strategies that include assistance with CMMI (Center for Medicare and Medicaid Innovation) participation and value-based and risk-based payment arrangements.

Claire routinely advises clients across the health care industry in operational and administrative responses to immediate jeopardy and health privacy breach allegations and threatened CMS (Centers for Medicare & Medicaid Services) termination actions. She also assists clients in responding to state and federal Office of Inspector General investigations and disclosures and audits and advises clients on repayments and remediation strategies to private payors and state and federal agencies, including the Medicare and Medicaid program.

Claire is a voting member of the National Native American Bar Association and Fellow of the American Bar Foundation. She has previously served on the American Bar Association Health Law Section's eSource editorial board and as the Section's vice chair of the Payment and Reimbursement Interest Group, vice chair of the Membership Committee, and member of the Planning and Marketing Committees for Emerging Issues and Washington Health Law Summit.

Esperienze

  • Digital health company expands telehealth programming in response to the COVID-19 public health crisisJones Day represented a digital health company in the expansion of their telehealth programming in response to the COVID-19 public health crisis.
  • Arsenal Capital Partners acquires HistoGeneX and Caprion BiosciencesJones Day advised Arsenal Capital Partners on major investments in HistoGeneX and Caprion Biosciences and the subsequent combination of the two businesses.
  • Ambry Genetics sold to joint venture formed by Konica Minolta and Innovation Network for up to $1.0 billionJones Day advised Ambry Genetics Corporation, a leading genetic testing corporation, in its sale to a newly formed joint venture between Konica Minolta, Inc. and Innovation Network Corporation of Japan for up to $1.0 billion (including earnouts).
  • Health care management company conducts internal investigation relating to alleged overpayment of federal health care fundsJones Day represented a privately-owned health care management company in an internal investigation relating to alleged overpayment of federal health care funds.
  • Health care management company reviews compliance with Medicare regulationsJones Day provides ongoing counseling, training, and advice to a health care management company regarding compliance with federal and state health care regulations.
  • Major academic medical center forms Medicare accountable care organizationJones Day represented a major academic medical center in connection with the formation of a Medicare accountable care organization ("ACO"), including hundreds of providers in a distributive, shared governance model.
  • Health care services company successfully resolves FCA retaliation suitJones Day represented a health care services company in a suit brought by a former employee asserting claims of retaliation for allegedly investigating and reporting violations of the False Claims Act by the company.
  • California hospital obtains dismissal of qui tam actionJones Day successfully defended a California healthcare district and hospital against an investigation conducted by the U.S. Attorney's Office for the Northern District of California, the Department of Justice Civil Frauds Section, the California Office of the Attorney General, and the Health and Human Services/Office of Inspector General.
  • Abbott purchases option to acquire Cephea Valve TechnologiesJones Day advised Abbott Laboratories in the providing of capital and securing of an option to purchase Cephea Valve Technologies, a private company developing a catheter-based mitral valve replacement therapy.
  • Community hospital seeks compliance advice on graduate medical education programJones Day assisted a community hospital in developing a compliance strategy for its residency program relating to its graduate medical education accreditation, including coordination and discussions with Centers for Medicare and Medicaid Services as to its administration of graduate medical education slots distributed as part of federal health care reform.
  • Ensign Group completes public offering of Common StockJones Day advised The Ensign Group, Inc., the parent company of the Ensign (TM) group of skilled nursing, rehabilitative care services, assisted living, home health, home care, hospice care and urgent care companies, in connection with its public offering of 2,733,617 shares of Common Stock.
  • Dignity Health wins dismissal of 32 casesJones Day secured the dismissal of 32 separate cases brought against Dignity Health's St. Bernardine hospital over spinal implants.
  • Ambulatory surgery center enters into buyout with partners and converts to outpatient departmentJones Day represented an academic medical center in the buyout of its joint venture partners in an ambulatory surgery center.
  • Celtic Healthcare and Allegheny Health Network complete joint venture to combine home health and hospice assets in western PennsylvaniaJones Day advised Celtic Healthcare, Inc., a majority owned subsidiary of The Graham Holdings Company and an innovative leader in the delivery of home health care in Pennsylvania and Maryland, in the formation of a joint venture with Allegheny Health Network that will combine each organization's home health and hospice assets in the western Pennsylvania region to create a new, fully integrated and industry-leading provider of post-acute care services operating under the AHN brand and managed by Celtic's support service and leadership team.
  • Fortune 500 life sciences company acquires medical device developerJones Day advised a Fortune 500 life sciences company in its acquisition of a developer of medical devices for approximately $250 million in cash.
  • Medical center resolves investigation regarding 340B purchasing practicesJones Day successfully negotiated a multi-million dollar settlement with the State of California, Health and Human Services Agency, Department of Health Care Services on behalf of a medical center regarding Medicaid reimbursement practices related to the 340B drug discount program.
  • Celtic Healthcare acquires VNA-TIPJones Day advised Celtic Healthcare, Inc., a majority owned subsidiary of The Graham Holdings Company and an innovative leader in the delivery of home health care in Pennsylvania and Maryland, in its acquisition of the assets of VNA-TIP HealthCare, a premier home health, hospice and private duty agency in Illinois and Missouri.
  • Community hospital successfully negotiates debt obligationsJones Day successfully negotiated and documented the out-of-court restructuring of obligations for a 100+ bed acute care regional hospital in California, enabling it to reduce its projected debts by more than $155 million and avoid a chapter 11 filing.
  • Bon Secours St. Mary's Hospital accepted to participate in Medicare Bundled Payments for Care Improvement programJones Day assisted Bon Secours St. Mary's Hospital in connection with the development of a bundled payment program for lower extremity joint replacements (knee and hip revisions) and the hospital's successful application for participation in Model 2 of the Medicare Bundled Payments for Care Improvement program.
  • CIT Group provides acquisition financing for provider of accounts receivable management servicesJones Day represented The CIT Group/Business Credit, Inc., as administrative agent, lead arranger, and lead bookrunner, in connection with a sponsor acquisition financing for a provider of accounts receivable management services to the nation's leading credit grantors and its subsidiaries and affiliates.
  • Seminari e convegni

    • September 14, 2017
      Trends in Clinical Trials, Regulatory Risks and Strategies for Commercialization, Fourth Annual ABA Life Sciences Legal Summitt
    • April 24, 2017
      Planning for MACRA, Health Reform, and Reimbursement Changes
    • July 26, 2016
      CMS 60-Day Rule (Intermediate), AHLA Distance Learning Series
    • May 21, 2014
      Responding to Licensing and Certification Deficiencies, California Hospital Association
    • April 17, 2014
      Increased Focus on Enforcement in Clinical Research - Lessons from Recent Cases, San Diego Regulatory Affairs Network
    • February 2013
      Healthcare Data Security: Practical Tips For Managing Risk From Legal and Enforcement Perspective, ABA Emerging Issues Conference
    • October 17, 2012
      Jones Day / Navigant 16th Annual Health Care Compliance Forum
    • June 18, 2012
      Lessons Learned: What Providers and ACOs Looking to Participate in 2013 Should Anticipate, AHLA Webinar
    • March 1, 2012
      AHLA Healthcare Fraud and Abuse Bootcamp Webinar Series, Part III: The Federal Anti-Kickback Law: An Overview, Recent Enforcement Trends and Impact of Healthcare Reform
    • October 20, 2011
      Payment Reform and Its Implications for Your Health System, 15th Annual Health Care Compliance Forum
    • 2011
      Health Reform - Understanding the Law, University of California Compliance & Audit Symposium
    • 2010
      Understanding POLST Forms, Fresno County Bar Association
    • 2009, 2008, 2007, 2006
      Annual Health Care Fraud and Abuse Education Updates, American Association of Professional Coders, Fresno Chapter
    • 2009
      Medical Identity Theft and Red Flag Rules, Central Valley of California
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