Peter D. Ricoy
A transactional healthcare and insurance regulatory lawyer, Peter Ricoy counsels clients on healthcare law, insurance regulation, mergers and acquisitions (M&A), data security and privacy, long-term care regulation, and general corporate and business transactions. Peter works hard to understand the unique circumstances of each of his clients, and is energetic, enthusiastic and passionate in helping them achieve their business objectives.
Peter works with health plans, hospitals, insurers, physicians, coordinated care organizations, independent practice associations, patient safety organizations, skilled nursing facilities, assisted living facilities and Medicare Advantage plans. He advises clients on issues related to healthcare reform under the 2010 Patient Protection and Affordable Care Act Oregon Insurance Code, Washington Insurance Code, Stark law, False Claims Act, Anti-Kickback Statute, Medicare, Medicaid, reimbursement, Health Insurance Portability and Accountability Act (HIPAA), and Employee Retirement Income Security Act (ERISA) health plan matters.
Peter has worked with insurance companies on regulatory matters related to requirements, rate and form approvals, form filings, licensing requirements, and company and product registrations. He has considerable experience representing clients before government agencies, including the Office of Inspector General, Office of Civil Rights, and the Oregon Insurance Division. Peter has also guided clients through complex mergers and acquisitions, including obtaining required regulatory approvals from the Oregon Insurance Division.
- Represented a large health insurer in analyzing the impact of healthcare reform (PPACA) on insurer’s operations and in implementing appropriate changes.
- In an M&A transaction, represented a hospital district in the sale of its hospital to a larger regional nonprofit hospital system.
- Guided a client through Medicare regulations related to "incident to" supplies and services and supervision requirements to ensure client eligibility for appropriate level of Medicare reimbursement.
- Represented a large multispecialty clinic as it converted from a limited liability partnership to a professional corporation without disrupting Medicare reimbursement.
- Represented a physician in a hospital dispute concerning revocation of privileges under Medicare's change of ownership (CHOW) regulations.
- Provided guidance to a physician group on physicians' rights under Oregon law to create medical liens and collect amounts owed to the physicians.
- Reviewed antitrust considerations pertaining to data dissemination and sharing agreement between healthcare entities.
- Drafted a facility lease agreement between hospitals.
Insurance Regulatory Matters
- Served as Associate General Counsel with Cambia Health Solutions, a healthcare company holding several insurance company subsidiaries collectively serving more than two million members in the Pacific Northwest/Intermountain region, including Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah, Regence BlueShield (in select Washington counties), and Asuris Northwest Health. Helped a client obtain a certificate of authority as a healthcare service contractor under the Oregon Insurance Code.
- Obtained regulatory approval for a client to operate as a licensed Life Settlement Provider in Oregon.
- Represented a captive insurance company in securing eligibility to transact business in several states, including Oregon, Washington, Wyoming and Utah.
- Represented an insurance producer in the sale of insurance accounts and related business.
Data Security and Privacy
- Successfully represented a client in response to an Office of Civil Rights investigation in response to a self-reported data breach.
- Advised a patient safety organization on matters related to regulatory requirements, data security and de-identification requirements.
- Successfully helped an assisted living and memory care facility obtain licensure from the Oregon Department of Human Services.
- Guided clients through all aspects of senior housing regulations in Oregon, including licensing requirements, change of ownership for assisted living and residential care facilities, change of administrators, change of Medicaid contract and change in management entity.
Memberships & Awards
- Oregon Hispanic Bar Association, Member
- American Bar Association, Health Law Section, Member
- Hispanic National Bar Association, Member
- Oregon Health Lawyers Association, Member
- American Health Lawyers Association, Member
- Oregon Minority Lawyers Association, Member
- Hispanic National Bar Association, Top Lawyer Under 40 award (2009)
Oregon Super Lawyers, Healthcare (2016)
Resources & Ideas
- August 1, 2016
- June 11, 2014
- June 9, 2014
- November 12, 2012
- February 16, 2012
- February 22, 2011
Seminars & Speaking Engagements
- Webinar, June 16, 2016
HIPAA and HITECH Act Fundamentals," American Bar Association Health Law Section, National Webinar, August 14, 2014
"Clinical Integration, the Alignment of Incentives, and CMS Quality-Based Payment Programs," Adventist Health Managers Network, July 15, 2014
"Clinical Integration, Health Care Information, and the Alignment of Incentives," Schwabe, Williamson & Wyatt Client Breakfast Presentation, Portland, Oregon, May 14, 2014
"CMS Quality Based Payment Reform Initiatives, Health Care Compliance Association," San Diego, CA, April 1, 2014
"Health Care Issues in M&A Transactions," Schwabe, Williamson, & Wyatt Presentation, Portland, Oregon, March 23, 2014
"Coordinated Care Organizations: a Deeper Look at Selected Issues," Willamette University Health Law Class Presentation, Salem, OR March 17, 2014
"Cyber Security Risk For Business Today," Luminant Digital Security, Beecher Carlson, & Schwabe, Williamson & Wyatt sponsored presentation, Portland, OR January 28, 2014.
"Managed Care Fundamentals," American Bar Association Health Law Section, National Webinar American Bar Association Health Law Section, January 23, 2014
"Health Reform Impacts: Focus on Employers," Regence BlueCross BlueShield of Oregon Employer Summit, Portland, OR, September 19, 2013.
"Transacting Business Amidst Rapid Regulatory Reform," Hispanic National Bar Association Annual Conference, Denver, CO, September 6, 2013.
Health Law Notes – Business Associate and Breach Reporting Changes, Healthcare Privacy & Security Forum, Lake Oswego, OR, July 18, 2013.
"Oregon's Health Insurance Exchange in 2014," Oregon Ambulatory Surgery Center Association Conference, November 8, 2012.
"Impact of the Supreme Court's Health Care Decision," Schwabe, Williamson, & Wyatt sponsored client event, Portland, Oregon, June 28, 2012.
"Oregon's Coordinated Care Organizations: A Deeper Look at Selected Issues," Adventist Health Portland, Health Managers Network, Portland, OR, April 26, 2012.
"Oregon's Coordinated Care Organizations," 2012 Oregon Ambulatory Surgery Center Association Community Care Organizations Seminar, Portland, OR, March 21, 2012.
"Health Reform Update," City of Corvallis seminar sponsored by Beecher Carlson, Corvallis, OR, January 2012.
"What Makes My Blue Plan Special? Insurance Requirements Inside and Outside the Health Care Exchanges," 2011 Blue Cross Blue Shield Association Blue National Summit, Chicago, IL, December 4-7, 2011.
"Employer-Provided Health Insurance in 2014 and the Health Insurance Exchange," Portland Metropolitan Payroll Association, October 19, 2011.
"Employer-Provided Health Insurance in 2014 and the Health Insurance Exchange," Associated Builders and Contractors Seminar, Portland, OR September 22, 2011.
"How the New Federal Health Care Law Will Affect the Business Community," Hispanic National Bar Association, Annual Convention, Dallas, TX, September 1, 2011.
"Health Care Reform and the Advent of the Health Care Exchanges in 2014," Seminars sponsored by Schwabe, Williamson & Wyatt and Beecher Carlson, July/September 2011.
"Accountable Care Organizations and Oregon's Coordinated Care Organizations: Preliminary Look at Proposed Regulations and the New Law," Oregon State Bar Health Law Section Brown Bag Lunch CLE, Portland, OR, June 2011.
- ABA Health eSource, May 2013, May 1, 2013
- American Bar Association, Health Law Section, eHealth Privacy & Security Interest Group, Former Vice Chair (2013-2015)
- American Bar Association, Health Law Section, Distance Learning Committee, Former Vice Chair (2013-2015)
- City Club of Portland, Former Governor and Treasurer (2014-2015)
- Oregon Hispanic Bar Association, Former President (2012-2013)
- Oregon State Bar, Health Law Section, Member, Former Chair
- Oregon Community Foundation, Advisory Committee of the Latino Partnership Program, Former Member (2013-2015)
- Lewis & Clark Law SchoolJuris Doctor degree, cum laude (2005)
- University of MichiganBachelor of Arts degree, Political Science (1992)
Oregon State Courts
Washington State Courts
Outside The Office
- Practicing and teaching Tae Kwon-Do as a third-degree black belt, bicycling and spending time with my family.