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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 represents many types of healthcare businesses, including hospitals, health systems, ambulatory surgery centers, medical billing companies, independent practice associations, clinics, and medical groups. 

Ms. Simer is the former Chair of the Health Law Committee of the State Bar of California’s Business Law Section. She is currently a member of the Orange Coast College Foundation Board of Directors. Julie 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 Health Care Providers Can Adapt and Succeed,” the featured article in the October 2015 edition of the Journal of Health & Life Sciences Law.

Ms. Simer has significant experience in the areas of regulatory compliance, managed care, and privacy, as well as the operational challenges facing the health care industry, including:

Hospital, Health System, and Ambulatory Surgery Center Operations
Managed Care Reimbursement and Contracting
Fraud and Abuse (Anti-kickback, Stark Law, and False Claims Act)
Managed Care Payment, Contracting and Reimbursement
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

Compliance

  • Designed and implemented a compliance program for health system 
  • Delivered EMTALA training to emergency department personnel  
  • Provided compliance training for  boards of directors, executives, compliance officers, attorneys, and personnel of health systems
  • Assisted ambulatory surgery centers with reinstatement into Medicare program
  • Prepared corrective action plan for ambulatory surgery center
  • Developed code of conduct and compliance plan for medical group

Managed Care and Reimbursement

  • Provided advice to many types of healthcare clients on managed care contracts and reimbursement issues
  • Prepared primary care and specialty physician agreements for independent practice associations
  •  Supervised outside counsel in managed care litigation against major health plans
  • Represented healthcare clients in mediation, arbitration, and litigation
  • Advised clients on Medicare and Medicaid overpayment demands and appeals
  • Provided training on MACRA to health system executives
  • Provided advise on ERISA plans to various types of entities and assisted with appeals of denials by ERISA plans

Fraud and Abuse

  • Analyzed many types of legal arrangements for compliance with Anti-kickback, Stark, and state law equivalents, including medical directorships, on-call agreements, and recruitment agreements
  • Advised entities on structuring joint ventures for legal compliance
  • Conducted internal investigations of possible False Claim Act issues
  • Advised clients on self-reporting 
  • Responded to governmental subpoenas and investigations

Privacy

  • Provided HIPAA training to hospital systems’ compliance officers and boards of directors
  • Prepared business associate agreements and notices of privacy practices for various companies
  • Developed HIPAA policies and procedures and advised clients on risk assessments
  • Conducted internal investigations and provided advice on reporting of privacy breaches
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

Orange Coast College Foundation, Board Member

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

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

Arizona Association of Health Care Lawyers

Health Care Compliance Association

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