Health care is one of the most highly regulated industries in the United States. Add the rules surrounding Medicare and Medicaid reimbursement, and it's easy to get lost in red tape. Today's health care providers need an attorney who understands the complexities of their business as well as the legal challenges they face. That's where Carla Cox comes in. Carla has more than 30 years' experience representing health care providers in Texas. During that time, she has earned a reputation for helping her clients adapt and thrive in a challenging regulatory environment.
"My rule has always been that I need to know as much – if not more – about my clients' businesses as they do," she said. "No matter how good I am as a lawyer, I have to understand what they do, how they get paid, who regulates them, and what their problems are in order to provide the representation they deserve."
Carla has seen the challenges her clients face on both sides of the regulatory equation. She began her career in the Texas Attorney General's Office, handling litigation for various state agencies. "That was a great opportunity for a young lawyer," she said. "Right out of law school, I had the chance to work in state and federal courts all over the state, as well as to argue 30-plus cases in appellate courts, including the Texas Supreme Court."
When she began private practice, Carla frequently represented clients before the Texas Health Facilities Commission, which at the time was in charge of providing certification for every health care facility in the state. That early experience has served Carla well throughout her career, as she has seen firsthand how shifting regulations affect her clients. She also knows how easy it is to run afoul of the myriad state and federal requirements, and she puts that knowledge to work helping her clients avoid – and recover from – enforcement actions.
"These systems have become so complex that clients can get themselves into trouble inadvertently," she said. "Once they've recognized there's a problem, they need assistance resolving that in the least painful way possible. That's where I'm able to hold their hand and help them put things right."
In one such case, Carla represented a client that was facing more than a half million dollars in civil monetary penalties as a result of deficiencies at a nursing home facility, which the client felt had been unfairly singled out for enforcement. Through skillful negotiation, Carla achieved a significant reduction in the monetary penalties as well as in the scope and severity of the deficiencies, which would have had implications for future sanctions.
"No matter how good I am as a lawyer, I have to understand what they do, how they get paid, who regulates them, and what their problems are in order to provide the representation they deserve."
– Carla Cox
Of course, sometimes an ounce of prevention is worth a pound of cure, and Carla also helps her clients develop proactive strategies to maintain compliance with all state and federal regulations as their operations change and grow. That includes providing counsel in connection with regulatory due diligence, license applications, and changes of ownership. It also entails serving as an advocate for clients in reimbursement issues and contractual disputes.
For example, Carla once represented a major national consulting firm that had received an important contract from a large state agency. Carla's client performed exceptionally well, and, because compensation was keyed to performance, was entitled to a larger payout than the state was willing to provide. Through patience and persistence, Carla was able to negotiate a settlement with the state that resulted in much higher compensation for her client than what was originally offered.
Carla's deep understanding of the state and federal procurement process has made her one of the foremost attorneys in Texas for representing clients involved in bidding challenges. She has successfully defended winning bidders against challenges and helped unsuccessful bidders assess and challenge awards to others. Working closely with attorneys in Jackson Walker's Legislative practice, Carla helps her clients position themselves for success in a difficult market.
"The state is such a large consumer of services that this has become a highly competitive area," she said. "By knowing what the remedies are and how best to use them, we are able to offer our clients a tremendous advantage in dealing with those procurement and contracting issues."
Taking time to get to know the issues – and her clients – is what sets Carla apart.
"Health care is an extremely specialized and increasingly complex business, and you have to take the time to really understand your clients' business," she said. "That's the only way to gain their trust."
No matter what changes lie ahead, Carla's clients know they can trust her to help them stay ahead of potential problems and on a path to success.
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