A highly accomplished and forward-thinking Assistant General Counsel and Attorney with a proven track record of advising executives in the healthcare industry in mergers, acquisitions, revenue cycle management, insurance recoveries, compliance, reorganizations, and regulation (including Medicare and Medicaid). A professional history of multiple client successes in financial recoveries, litigation defenses and strategies for hospital systems, medical providers, and healthcare payors, including strategic business counseling for financially challenged organizations.➤ M&A➣ Directed multiple healthcare facility acquisition initiatives, including Attorney General, FTC, approval, and antitrust challenges. ➣ Created the then-largest physician-owned Medicare health plan, with follow-on growth strategies leading to a $600M sale. ➣ Negotiated and guided managed care, risk sharing agreements among hospital systems, primary and multidisciplinary medical groups, and Medicare and commercial payors.➣ Directed the purchase of 300-bed acute hospital campus, including facility and medical office structures.➣ Oversaw the sale or acquisition of facilities, including hospitals and medical offices.➣ Provided the legal counsel and supervised the sale of underperforming medical facilities.➤ Insurance Financial Recovery and Revenue Cycle Enhancement➣ Headed the healthcare system's initiative to recover $980M in insurance company receivables.➣ Spearheaded the system's strategies to recover $285M in casualty losses from devastating Californiawildfires (recovering from both the system's casualty insurer and a bankrupt California utility).➤ Services for Hospitals / Health Facilities➣ Guided the developed of strategies for joint ventures with physician hospitals and clinical laboratory. Integrated health systems (regional hospital system with primary care medical groups).➣ Created, licensed, and accredited ambulatory surgery centers.➣ Guided multiple hospitals in the governance of the physician and affiliated providers of the medical staff.
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Legal CounselAdventist Health 2015 - 2023Roseville, California, United StatesRecruited to help build and manage an in-house legal department. The charter was to reduce legal expenses while supporting an ambitious acquisition strategy. Provided legal and regulatory advice to corporate executives and company entities on a wide variety of legal and business issues.➤ For M&A and Insurance Financial Recovery & Revenue Cycle Enhancement, please see the About section above. Additional areas of focus included:➤ Regulatory Compliance➣ Developed and licensed a network for first physician-owned Medicare HMO in California in six months (record time over average two years).➣ Created a Medicare Advantage HMO ESOP after lengthy negotiations with state and federal regulators due to complex capital restructuring.➣ Prepared and delivered the legal defense of multiple surgery centers against decertification by Medicare.➣ Oversaw the development of company policies that ensured compliance with HIPAA regulations.➤ Licensure and Credentialing➣ Provided medical staff counseling to acute hospital facilities and multidisciplinary medical groups; devised the legal strategy to respond to medical staff peer review disputes and appeals.➣ Oversaw licensing of Medicare Advantage HMOs.➤ Services for Hospitals / Health Facilities➣ Guided the developed of strategies for joint ventures with physician hospitals and clinical laboratory.➣ Integrated health systems (regional hospital system with primary care medical groups).➣ Created, licensed, and accredited ambulatory surgery centers.➣ Guided multiple hospitals in the governance of the physician and affiliated providers of the medical staff (including disciplinary actions, judicial review hearings, and creation and implementation of the medical staffs', bylaws, rules, and regulations). -
PartnerPolsinelli 2013 - 2015Los Angeles Metropolitan AreaOversaw daily operations of the firm and served as mentor and advisor to less senior lawyers and staff. Responsible for growing the clientele and developing new business opportunities.➣ Facilitated successful defense and ultimate nominal settlement of national hospital systems against RICO and fraud claims involving joint venture with alleged bogus surgical program.➣ Led defense of national hospital system against claims of unlawful billing of uninsured patients.➣ Prosecuted underground citizens’ group’s paper campaign to undermine hospital physician joint venture.➣ Facilitated defense by summary judgment of physician group / hospital integrated delivery system against qui tam claims of fraud and kickbacks and violation of state charitable contribution laws.➣Performed multiyear defense and prosecution of risk sharing, unfair competition, and unlawful interference claims involving breakup of hospital physician joint venture.➣ Defended multiple physician groups against claims of unlawful physician recruiting and patient stealing.➣ Led prosecution to favorable settlement of prominent IPA for unfair competition and conversion (theft ofpatient files and patient data); settlement included payment of clients’ attorneys’ fees.➣ Defended physician group against bankrupt hospital chain’s claims of risk sharing funds and unlawful diversion of funds.➣ Prosecuted risk sharing and bonus payments against national HMO.➣ Led prosecution of patent infringement of illegally imported ultra-wave device to settlement.➣ Represented hospital and skilled nursing systems in negotiations and contracting for data sharing, electronic medical
Robert Layton Education Details
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Doctor Of Law - Jd -
Economics
Frequently Asked Questions about Robert Layton
What is Robert Layton's role at the current company?
Robert Layton's current role is Healthcare Legal Executive & Assistant General Counsel | M&A | Insurance Financial Recovery & Revenue Cycle Enhancement.
What schools did Robert Layton attend?
Robert Layton attended University Of California, Davis, University Of California, Davis.
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Robert Layton
Chief Financial Officer At Kansas City Kansas Community CollegeKansas City Metropolitan Area -
1gmail.com
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1morawealth.com
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1kckcc.edu
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