Nina Adatia Marsden

Nina Marsden advises hospitals, hospital systems, pharmacies, and other healthcare providers (both inside California and nationwide), on legal issues connected with transactions, operations, and reimbursement by the Medicare and Medicaid programs. 

Nina serves as the firm’s licensing and certification expert, regularly advising health care providers on various licensing and certification issues, from day-to-day operational issues to management of licensure and certification issues in the face of complex and ongoing business transactions. In her change of ownership work, Nina guides clients through the regulatory processes and issues associated with acquisitions, reorganizations, sales, and mergers of health care facilities, helping clients procure state and federal health care licenses and approvals and advising clients on the transition of operations. She manages constantly evolving deal structures and timelines, and develops and implements work plans that address a range of state and federal regulatory approvals with the goal of timely achieving clients’ desired transactional results. 

Throughout these transactions, she works meaningfully and effectively with federal and state regulators, the client’s deal counsel and executive team, seller’s counsel, and operations teams to manage regulatory issues. Nina is particularly well-known for her in-depth knowledge of California pharmacy law, and has years of experience working with the California State Board of Pharmacy and navigating pharmacy licensure issues.

Nina also assists clients with issues relating to Medicare reimbursement, challenging both Medicare Administrative Contractors’ payment policies for specific services as well as systemic reimbursement issues facing hospitals before the Provider Reimbursement Review Board (“PRRB”). She manages PRRB appeals for small hospital systems, reviewing adjustments, identifying issues to appeal, and implementing and managing appeal strategy. She has also advised on and managed larger group appeals involving over 500 hospitals each.

Nina is a leader both inside the firm and in the profession. She is the Chair of the firm’s COVID-19 Task Force and a member of the its Health Equity Task Force and Diversity & Inclusion Committee. She regularly presents to clients and trade associations on various healthcare regulatory developments and compliance issues, Medicare reimbursement issues, and the regulatory challenges associated with healthcare transactions.  

Representative Matters

• Regulatory counsel to a hospital in the aftermath of a natural disaster, advising the hospital regarding complex licensure, accreditation, and certification issues, including interactions with the California Department of Public Health and the Centers for Medicare and Medicaid Services, to strategize and manage its ability to continue to provide much-needed health care services to the community.
• Management of change of ownership process in connection with a California healthcare system’s transaction to purchase seven long-term acute care hospitals and two skilled nursing facilities across seven states, including management of regulatory processes, analysis, and diligence; interactions with various state and federal agencies; and change of ownership filings for state and federal healthcare approvals 
• Management of change of ownership process in connection with the reorganization of a California healthcare system involving three hospitals, including analysis and advice regarding timing and operational transition issues, as well as management of change of ownership filings for state and federal healthcare approvals 
• Management of change of ownership process in connection with a California hospital system’s acquisitions of new hospitals, including analysis and advice regarding timing and operational transition issues, as well as management of change of ownership filings for state and federal healthcare approvals 
• Representation of over 600 hospitals across the nation in challenging the Centers for Medicare & Medicaid Services’ unlawful continuation of a temporary and limited payment reduction to the Medicare Inpatient Prospective Payment System, involving approximately $5 billion in payment reductions to Medicare hospitals
• Representation of over 2,000 hospitals in challenging an unlawful reimbursement reduction to the Medicare Inpatient Prospective Payment System, involving management of hundreds of Provider Reimbursement Review Board appeals and negotiation with the Centers for Medicare and Medicaid Services to ultimately secure $700 million settlement
• Successfully appealed the revocation of hospital pharmacy Medicare enrollment, allowing a hospital to bill over $1 million of Medicare services
• Assisted a California hospital in successfully challenging its Medicare Administrative Contractor’s (MAC) denial of coverage for certain IVIg services for transplant patients, involving careful analysis of the MAC’s guidelines for coverage and payment for the service
• California regulatory counsel to a national medication management and distribution pharmacy company related to its California operations, regularly advising on the company’s California pharmacy licensing and Medi-Cal enrollment issues, including changes in location and multiple corporate reorganizations.
• Regulatory counsel to a multi-state pharmacy in connection with its California operations, regularly advising on the company’s California pharmacy licensing issues, including initial licensure and change of ownership.