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Nossaman LLP

Julie A. Simer

Partner

T 949.477.7642
F 949.833.7878
18101 Von Karman Avenue, Suite 1800
Irvine, CA 92612

Julie Simer is a Partner in the Healthcare Practice Group.  She draws upon thirty years of legal experience providing practical solutions to complex problems facing hospitals, health systems, health plans, ambulatory surgery centers (ASCs), independent practice associations (IPAs), medical groups, medical billing companies,  and other healthcare and non-healthcare businesses. 

Ms. Simer helps her clients maximize revenue, reduce costs, and remain compliant in the ever-changing healthcare environment. Julie is the former Chair of the Health Law Committee of the State Bar of California’s Business Law Section.  She is the co-author of the “Health Plan Dispute and Litigation Practice Guide” published by the American Health Lawyers Association in 2015 and the “Wide World of Narrow Networks: How Healthcare Providers Can Adapt and Succeed,” the featured article in the October 2015 edition of the Journal of Health & Life Sciences Law.

Julie has significant experience in the areas of regulatory compliance, managed care, and privacy, as well as the operational challenges facing the healthcare industry, including:

  • Managed Care Reimbursement and Contracting
  • Healthcare Fraud and Abuse Laws (Anti-kickback Statute, Stark Law, False Claims Act)
  • Managed Care Payment, Contracting and Reimbursement
  • Revenue Cycle and Operations Management
  • Health Plan and Provider Litigation and Alternative Dispute Resolution
  • Healthcare Reform (Accountable Care Act) and Healthcare Policy
  • Contracting with Physicians (Medical Directorships and Recruitment Agreements)
  • Healthcare Compliance Department Formation and Operation (Policies, Training, Audits)
  • Healthcare Privacy and Security (HIPAA and CMIA)
  • MACRA, Medicare Shared Savings (ACOs), and other Medicare Payment Programs
  • Medicaid Reimbursement (Medi-Cal and AHCCCS)
  • Healthcare Facility Licensing

Representative Work

  • Providing advice on the Stark law, Anti-kickback Statute, Civil Monetary Penalties Law, the False Claims Act and other state and federal statutes and regulations aimed at reducing fraud and abuse in healthcare business transactions
  • Reviewing managed care contracts and providing guidance on health plan-provider reimbursement, contracting, and state and federal statutory and regulatory requirements, including California’s Knox-Keene Act and corresponding regulations
  • Advising clients on out-of-network reimbursement issues 
  • Guiding clients through regulatory issues with respect to joint ventures, acquisitions, and sales of healthcare facilities, including corporate practice of medicine issues and health facility licensing
  • Interpreting Medicare regulations related to enrollment, reactivation, overpayments, appeals, and value-based payment programs 
  • Advising health plans on fair hearing procedures and preparing primary care and specialty care provider agreements
  • Preparing medical directorship and recruitment agreements
  • Providing guidance on Medicaid issues, including application of the Mega-Reg
  • Delivering training to boards of directors on compliance and corporate governance responsibilities. 
  • Providing HIPAA and cybersecurity training
  • Developing policies for data management, storage, routine destruction, litigation holds, and HIPAA compliance
  • Preparing business associate agreements and other necessary documentation for compliance with HIPAA and the HITECH Act and assistance with audits and risk assessments
  • Assisting clients with internal investigations and self-reporting compliance violations
  • Providing training on the Emergency Medical Treatment and Labor Act (EMTALA).
  • Assisting clients with responses to governmental subpoenas and investigations
Julie A. Simer
Julie A. Simer

Practices

Education

M.P.H., University of California, Berkeley, 2015

J.D., Drake University School of Law, 1986, with honors

B.S., University of Illinois, 1983, with honors

Admissions

Arizona

California

U.S. District Court, Central District of AZ

U.S. District Court, Central District of CA

U.S. District Court, Southern District of CA

Professional Affiliations

Arbitrator – American Arbitration Association

Quality Council, American Health Lawyers Association (AHLA), 2015-2017, Member

California Society for Healthcare Attorneys (CSHA), Education Committee Member

Arizona Society of Healthcare Attorneys

Orange Coast College Foundation, Board Member and Treasurer

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