Ms. Rush leads the Firm's Data Incident Response Team, which is a NetDiligence Authorized Breach Coach® firm. She assists clients in the investigation of and response to privacy and security incidents. She is a U.S. and Canadian Certified Information Privacy Professional and member of the Firm's Data Protection, Privacy and Cybersecurity Team. Ms. Rush also assists clients with managed care and insurance regulatory issues.
Privacy and Security
Ms. Rush counsels clients on the investigation of, and response to, privacy and security incidents and data breaches. She represents clients in investigations by the Office for Civil Rights, state attorneys general and insurance departments, and in litigation involving privacy challenges. She routinely advises clients on state and federal laws related to privacy and security of personal information, including HIPAA, Part 2 Substance Abuse laws, the Genetic Information Nondiscrimination Act, the Telephone Consumer Protection Act, the CAN-SPAM Act and state laws related to privacy protections and breach notification requirements. She has assisted clients in the development of policies and procedures for compliance with HIPAA and state and federal laws related to privacy and security. Her privacy and security experience includes:
- Assisting clients with response to security incidents, including phishing scams and ransomware attacks.
- Advising clients on notification requirements under state and federal breach notification laws.
- Representing clients in investigations by the Office for Civil Rights, state attorneys general and other state agencies that enforce privacy and security regulations.
- Assisting with review and development of privacy and security compliance manuals.
- Drafting and advising on business associate obligations and contracts.
- Reviewing and drafting website privacy policies.
- Assisting clients with development and testing of incident response plans.
Managed Care
Ms. Rush represents clients in regulatory, compliance, and operational issues related to managed care. She drafts agreements between health care entities including provider agreements for participation in IPAs, ACOs, TPAs, PPOs and Medicare Advantage and Medicaid managed care plans. She routinely counsels clients on state and federal legislation that impacts managed care contracting. Her managed care experience includes:
- Drafting and editing managed care contracts including IPA Participating Provider Agreements, ACO Participation Agreements, Medicaid Managed Care Participating Provider Agreements, PPO/Network Agreements, Commercial Health Plan Provider Agreements, Value Based/Risk Based Participation Agreements and Pharmacy Benefit Manager Agreements.
- Assisting providers with resolution of disputes with payers including disputes related to payment obligations and contract terminations.
- Preparing payment-related documents and agreements including assignment of rights, patient agreements to pay contracts and negotiated rate agreements.
- Advising clients on federal and state laws related to out-of-network payments and balance billing, including the No Surprises Act
- Counseling clients on state laws related to network adequacy, prompt pay provisions, "any willing provider" requirements, Medicaid managed care and Association Plans/Multiple Employer Welfare Associations (MEWAs).
- Advising clients on federal laws and regulations related to Medicare Advantage plans, Medicaid managed care plans, Affordable Care Act provisions related to plan benefit design and premium payment and coordination of Benefit provisions/Medicare Secondary Payer regulations.
- Assisting clients with the formation, registration and/or licensing of Health Maintenance Organizations, insurance companies, Third-Party Administrators, Utilization Review Agents, Preferred Provider Organizations/Networks, and Independent Physician Associations.
Insurance Regulatory
Ms. Rush routinely assists clients with insurance regulatory matters and is familiar with all lines of insurance including property and casualty, title, life, and health. Her work on insurance matters includes:
- Advising insurance companies on acquisitions, redomestications, mergers, formations and expansions, reinsurance, insolvency and holding company matters.
- Counseling clients on compliance and operational issues.
- Representing regulated clients before insurance departments around the country.
- Assisting clients with response to cease and desist orders, civil investigation demands and related regulatory proceedings.
- Assisting clients with preparation and filing of rate and form documents.
- Advising clients on insurance premium tax matters and on the handling of unclaimed property laws and regulations.
- Assisting insurance agents and brokers with obtaining licensure in all 50 states, advising agents and brokers on regulatory matters, and representing them in administrative actions.
- Counseling clients on compliance with insurance data security laws, drafting information security programs and assisting with cyber breach reporting obligations.
- Counseling clients on issues related to captive formation and operations.