We Strengthen the Safety Net

Carlos Zaffirini Jr.

Carlos is an accomplished health care attorney who has used his deep knowledge of the regulatory environment to build Adelanto HealthCare Ventures (AHCV), LLC, a health care finance consulting company with offices in Washington D.C., Austin, Nashville, and Laredo. AHCV focuses on reimbursement consulting for healthcare providers.  

As the President and CEO of AHCV, Carlos has helped some of the largest and most prestigious hospitals in the country access more than $6 billion of additional reimbursement. He has expertise and extensive experience in structuring complex Medicaid reimbursement models, including the following:

• multiple non-governmental Medicaid Upper Payment Limit (UPL) programs, 
• Local Provider Participation Funds (LPPFs)/provider taxes, 
• Medicaid Disproportionate Share Hospital programs, and 
• Medicaid Managed Care Rate Enhancement Projects. 

Carlos also works on complex regulatory issues with health systems, transportation providers, and managed care organizations. Most notably, he created and implemented the concept of the LPPF in Texas. Such initiatives generated more than $4 billion to help improve funding and delivery of care for the local healthcare safety-net system. The LPPF concept is now recognized as a preferred Medicaid financing model in Texas, and several other states are considering adopting similar measures based on Texas’ success with this model. 

To facilitate access to health care for patients who lack transportation for their medical visits, Carlos collaborates with the world’s largest Transportation Network Company (ride sharing) to develop innovative services that meet their needs. This includes assistance in developing a new reimbursement structure for ride sharing companies that help poor patients seeking access to care.

Jamie Richards Whitney

Jamie has more than a decade of experience as a trial and appellate lawyer.  She began her career as a law clerk for U.S. District Judge Sam Sparks in the Western District of Texas and then went on to try cases, first at an AmLaw 100 firm and later as a solo attorney and in a litigation boutique setting. Representative matters involving health care providers include the following:

• managed care reimbursement disputes, 
• antitrust suit involving medical devices, 
• physician partnership dissolutions, 
• contract dispute over development of medical office building, 
• contract dispute over multiple hospital physician-recruitment agreements, 
• managed care provider bid contests, and 
• court challenges to ultra vires state regulations affecting medical providers.
  

In addition to her litigation experience, Jamie spent valuable time as in-house contracts counsel for a Fortune 100 company, and managed the negotiation of multi-million-dollar commercial agreements in several industries, including pharmaceuticals and medical devices.