PRIVATE PRACTICE - Strategic Contracting Series - Module 6 - Learning Lawyer Speak

Gwen Simons, Esq, PT, OCS, FAAOMPT is a healthcare lawyer at Simons & Associates Law in Scarborough, Maine. Her law firm caters to the needs of health care providers in private practice, representing providers in contract negotiations/disputes with payers and providing Medicare/HIPAA compliance and practice management consultation. She’s also been a fearless advocate for physical therapy issues, taking on the Goliath insurance carriers on prior authorization, payment, unfair contracting issues in Maine’s state legislature as the Maine Chapter APTA’s lobbyist. She has served on several PPS and AOPT Task forces on payment issues and is the 2023 recipient of the Maine Chapter’s President’s Service Award for her advocacy work to pass Maine legislation to prohibit insurance carrier prior authorization requirements before visit 12.

Bob Hall is the senior consultant handling payment issues for the APTA Private Practice. As Executive Chair of a solo consulting firm focused on improving access to affordable health care, he helps health professionals maximize their collective impact. From 2016-2018, Bob was the Director of Government Relations at the American Academy of Family Physicians. Bob directed all legislative and regulatory advocacy for the AAFP, including oversight of the Academy's Center for State Policy. Bob was also elected to represent AAFP as the first Co-Chair of the Partnership for Medicaid, a nonpartisan, nationwide coalition made up of 23 organizations representing doctors, health care providers, safety net health plans, counties, and labor. Bob spearheaded the access to care portfolio at the American Academy of Pediatrics from 2006-2016, leading efforts to improve insurance coverage for children. Prior to his tenure at AAP, he served as Director of Government Relations for the National Coalition for Cancer Survivorship, Counsel to US Senator Mark Dayton, Attorney Advisor to the US Securities and Exchange Commission, and Chief Clerk to the Texas House of Representatives Insurance Committee. He holds a Master in Public Affairs from the LBJ School of Public Affairs, a Juris Doctor from the University of Texas School of Law, and a BA from Haverford College.