Scott Einiger is a senior partner and director of the New York City Health Law Practice at Abrams, Fensterman, Fensterman, Eisman, Greenberg, Formato & Einiger, LLP.
Mr. Einiger has extensive experience in health care law. He frequently represents physicians in professional conduct investigations, the purchase, sale and integration of medical practices, insurance fraud investigations, managed care disputes, audits, transactional work, regulatory compliance, and malpractice defense litigation.
A leader in his field, Mr. Einiger is Special Counsel to The New York County Medical Society and General Counsel to The American Academy of Psychoanalysis. He is counsel to the New York Society of Gastroenterology. He was also part of a comprehensive risk management/quality assurance program designed to reduce liability risks for health care professionals and hospitals insured with the Medical Liability Mutual Insurance Company, where he was counsel for 15 years.
Mr. Einiger helped initiate the national propofol reimbursement initiative launched against Aetna representing thousands of gastroenterologists and anesthesiologists in a coalition known as the GA alliance in 2008 joining with interested parties around the country (successfully). As well he initiated the mass arbitration lawsuit against Oxford on behalf of fifteen medical societies and hundreds of aggrieved physicians. He has lectured throughout New York, Boston, St. Louis and Arizona, and has authored published articles on many health care related topics including writing the forward for the national book, For Doctors Only. Mr. Einiger has won many important and novel cases, most notably Foong vs. Empire, a case of first impression in New York that was affirmed by the Appellate Division, First Department on May 29, 2003 and reported on the front page of the New York Law Journal. The case upheld a physician's right to bring a civil action against an HMO that terminated a physician without complying with Public Health Law (PHL) 4406-d due process requirements. The case also upheld a private right of action for bad faith reporting of a physician to the state licensure board under PHL 230.
Mr. Einiger received his J.D. from Brooklyn Law School and his B.S. in Political Science from Brooklyn College. He is admitted to practice in New York.
In March 2008, Mr. Einiger, was interviewed regarding his successful representation of the Gastroenterologist-Anesthesiologist Alliance (GA Alliance). The GA Alliance represents thousands of physicians in medical societies, private clients and other interested parties from across the country. The GA Alliance was united in interest, with the goal of stopping Aetna Health Insurance in its attempt to alter (reduce) its insurance coverage of anesthesia during colonoscopies and other endoscopic procedures.
Mr. Einiger working on behalf of the GA Alliance, was able to successfully stop Aetna from implementing its planned policy change concerning monitored anesthesia care during colonoscopies, which threatened access to this vital procedure. Mr. Einiger notified all fifty state attorneys general and governors from around the country about this untoward action. As Mr. Einiger explains to Lisa Wexler, host of "Live! With Lisa," that when Aetna first planned to implement this policy change, it failed to notify any of its over 16 million members, but rather chose to disseminate a press release.
Mr. Einiger discusses that colonoscopies are crucial to the prevention and detection of colorectal cancers, especially in light of the fact that colorectal cancers took the lives of more American last year, than were lost in the Vietnam War. Mr. Einiger successfully fought to preserve this crucial coverage which President George W. Bush was afforded, to assist in the prevention of one of the few truly avoidable and treatable cancers when diagnosed in its earliest stages.
|Senior Partner and Director of New York City Health Law Practice||Abrams, Fensterman, Fensterman, Eisman, Greenberg, Formato & Einiger, LLP||2006 - Present|
|Association name||Position name||Duration|
|New York County Medical Society||Special Counsel||N/A|
|New York Society of Gastroenterology||Of Counsel||N/A|
|American Academy of Psychoanalysis||General Counsel||N/A|
|Medical Society of the State of New York "News of New York"||Appealing Healthcare Claim Denials: Know Your Rights||2010|
|www.abramslaw.com||Proper Coding: Failure to Stay Abreast of the Law and Current Coding Practices Can Result in Civil Liability and Criminal Prosecution||N/A|
|www.abramslaw.com||Physician Disability Income Insurance Policies - Are All Policies Created Equal?||N/A|
|www.abramslaw.com||Limiting Professional Liability in Third Party Examinations||N/A|
|Brooklyn Law School||J.D.||N/A|
|Melville Marriot||“Everything You Need to Know About Forming an Office-Based Surgical Facility ” New Law, New Economics, New Liability||N/A|
|The New York Society for Gastrointestinal Endoscopy||Office Based Endoscopy - If you ARE certified: Maintaining Accreditation and Billing a Facility Fee!||N/A|
|Wachovia's Westchester Room||The Office-Based Surgery Roundtable||N/A|
|An Office Based Endoscopy Perspective||New York Society for Gastrointestinal Endoscopy 2009 Practice Management Seminar||N/A|
|Foong vs. Empire|
Posted by anonymous
Tue Oct 19 2010
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