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Introduction
Justin Pfeiffer is counsel in Nixon Peabody’s Healthcare group. Justin’s practice focuses on assisting healthcare providers as they navigate regulatory compliance, execute transactional matters, and participate in Medicaid, Medicare, and other government insurance programs.
Before joining NP, Justin directed the largest legal bureau of the New York State Department of Health, where he provided counsel to a variety of governmental clients, including the governor’s office and the Department of Health’s executive staff, on virtually every type of legal matter that came before the department.
My focus
I counsel all manner of healthcare providers with respect to regulatory compliance, audits and investigations by federal and New York agencies, and transactional matters, including mergers, sales, and acquisitions.
Looking ahead
The legal and business landscape in healthcare continues to rapidly evolve. Large private practice groups increasingly compete with state-licensed healthcare providers, and novel collaborative delivery models will be proposed that include multiple provider types. Both trends will create complex compliance and regulatory issues.
Healthcare providers will continue to merge, consolidate, and establish alignments and affiliations as they adapt to a changing economic and healthcare environment. Relatedly, the increasing focus by regulators on private equity’s participation in the healthcare space may change how stakeholders weigh the risks and benefits of these investment opportunities.
In the Medicaid and Medicare spaces, value-based payment (VBP) systems continue to develop. Providers should consider how to best align their healthcare delivery systems to demonstrate empirical value along defined metrics. Further, New York’s novel 1115 waiver program seeks to revolutionize services to Medicaid enrollees by permitting reimbursement for an array of social supports through an intriguing network of health and social support providers.
Finally, artificial intelligence presents incredible potential for efficiency and growth across the healthcare industry while also creating risks and openings for untested legal challenges.
Insights
- “Healthcare transactions under scrutiny with New York’s new law,” Bloomberg Law, May 11, 2023
- “Understanding OMIG's New Regulations: Provider Compliance Programs and Self-Disclosure,” Nixon Peabody Webinar, February 16, 2023 (speaker)
In the news
- Crain’s New York Business
DOH delays law to curtail surprise medical bills following provider backlash
Oct 28, 2024This article covers the New York State Department of Health’s decision to delay implementation of the “consent-to-pay” law while the agency addresses concerns raised by industry and advocacy groups. Albany Healthcare counsel Justin Pfeiffer is quoted in the coverage, discussing the ambiguity within the bill language and potential logistical barriers that could stand to harm healthcare businesses.
- The New York Sun
End of COVID ‘emergency’ will bring changes to American healthcare
Jan 31, 2023Albany Healthcare counsel Justin Pfeiffer is quoted in this article on the Biden administration’s plan to end the COVID-19 public health emergency in May, and how it may impact the healthcare industry. Justin explains how telehealth services could change and how the decision will be felt at the state level with expected decreases in Medicare and Medicaid funding.
- Crain’s New York Business
Clinical labs, blood banks could gain flexibility under new licensing proposal
Albany Healthcare counsel Justin Pfeiffer is quoted throughout this article on a New York Department of Health licensing proposal that would give clinical laboratories and blood banks more flexibility in who can serve as their directors and what tests they can conduct.April 8, 2022 - Crain’s New York Business
State proposes regulation to limit surprise out-of-network charges
This roundup article of notable health care news quotes Albany Health Care counsel Justin Pfeiffer for his outlook on how a proposed regulation by New York State’s Department of Financial Services, which would curtail out-of-network charges for patients who believed a provider was in-network due to incorrect health plan information, will lead to improved relationships between consumers and providers.Nov 29, 2021 - Bloomberg Law
Wake up call
The following roundup of notable legal news and moves highlight the arrival of Albany Health Care counsel Justin Pfeiffer, who is the former director of the New York State Department of Health’s Bureau of Program Counsel and focuses his practice on the state’s regulatory landscape.Aug 31, 2021 - New York Law Journal
Lawyers on the move
The following roundup of notable legal news and moves highlight the arrival of Albany Health Care counsel Justin Pfeiffer, who is the former director of the New York State Department of Health’s Bureau of Program Counsel and focuses his practice on the state’s regulatory landscape.Aug 30, 2021
Admitted to practice
New York
Education
Cornell Law School, J.D.
Harvey Mudd College, B.S.
Troy State University, M.S.I.R.
Recognition
Graduate, New York State Leadership Institute (2018)
Insights And Happenings
View AllProfessionals in the Practice Area
View AllLindsay Maleson
Partner / Practice Group Leader, Healthcare- Long Island
- Office:+1 516.832.7627
- lmaleson@nixonpeabody.com
-
Jill H. Gordon
Partner / Co-chair, Life Sciences Practice- Los Angeles
- Office:+1 213.629.6175
- jgordon@nixonpeabody.com
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