About Sara Granda

Sara M. Granda, Esq., MSW

Health Law Attorney

(smgranda@gmail.com)

EDUCATION

University of California, Davis, School of Law
J.D., 2009

  • Relevant Coursework: Patent Law, Reproductive Rights Law and Policy, Medical Liability and Policy, Health Law.

  • Personal accomplishments: Founding Member and President of the King Hall Healthcare Law Student Association, when needed serving as La Raza Law Student Association Co-Chair, pushing limits in understanding the complexities of immigration law, volunteering for naturalization workshops, serving as founding member of the first National Law Students with Disabilities Association (ABA Individual Rights and Responsibilities funded endeavor), and engaging in mediation the summer of my first year in law school regarding lack of accommodations for students in professional school versus graduate school versus undergraduate studies.

  • Honors: 2009 recipient of the Lorenzo Patiño Award for commitment to community service

California State University, Sacramento
M.S.W., 2006

  • Relevant Coursework: Advanced Policy, Advanced Statistics (SPSS, SAS, SaaS) and Theories of Criminal Behavior, and Medical Social Work in Hospital Settings

  • Honors: Phi Alpha National Social Work Honor Society; California Wellness Foundation Scholarship; Pillar Andrade Award for Academic & Community Excellence.

  • Personal Accomplishments: Opportunity to Conduct Original Research in Thesis Research, Writing and Publication, despite being deemed high risk by my IRB committee, Working in clinical placement at the UC Davis Medical Center permitted to engage new “outside the box” discharge, Case Management Modalities, and working indirectly on implementation of Prop 63’s creation of the Mental Health Services Act (MHSA)

California State University, Sacramento
B.A.S.W., Magna Cum Laude, 2004

  • Relevant Coursework: Victimless Crimes, Policy, Research Methodologies, Statistics, Pharmacology, Condensed Thesis: “Recidivism of Teenage Pregnancy in First Generation Latinas with Immigrant Parents”

  • Honors: Sutter Health Scholarship Program; Venture Club Scholarship.

  • Personal accomplishments: Creating my own clinical practice field placement when told I did not have one due to “nobody wanting me” that “I couldn’t do anything” and that “I have to think that social work isn’t for me.” Field placement with Sutter West Medical Group setting up and entirely new practice in chronic pain management, functional medicine, facilitating group medical appointments with treating physician, and clinic nurse, teaching Stanford created chronic pain workshops. Developing meaningful life long relationships with incoming new professors as we navigated perceptions of students with disabilities and insight from their personal experiences with obstacles overcome. Advocating indirectly and directly for passage of Prop 63 that would create Mental Health Services Act (MHSA)

EXPERIENCE

Attorney
California Department of Health Care Services (DHCS), Sacramento, CA
2011–2023

Program Integrity and Legal Advisory

Fraud Prevention and Program Oversight

  • ACA Program Integrity: As Lead Attorney for ACA Program Integrity initiatives, created and implemented compliance processes, including:

    • Provider screening, suspension, and reinstatement protocols in alignment with federal and state mandates.

    • Fraud, waste, and abuse prevention measures in Medi-Cal, working closely with:

      • DHCS Investigations Branch

      • Bureau of Medicaid Fraud and Elder Abuse (BMFEA, now DMFEA)

      • Medi-Cal Audits and Investigations Branch

  • Qui Tam and Complex Investigations: Collaborated with the Attorney General’s Office on large-scale fraud cases involving Medi-Cal, including Qui Tam actions and disputes over Medicare and Medicaid fund misuse.

  • Litigation Support: Supported DHCS in administrative hearings and civil litigation, addressing healthcare regulation enforcement, funding misappropriations, and provider overpayments.

Regulatory Review and Legislative Impact Analysis

  • Policy and Regulatory Adjustments: Drafted and analyzed State Plan Amendments (SPA), Waiver Amendments, Trailer Bill Language, Bill Analyses, and policy proposals to ensure compliance with federal and state mandates.

  • Rule-Making Expertise: Developed, drafted, and implemented regulatory packages under the Administrative Procedures Act (APA). Collaborated with the Office of Administrative Law on regulation reforms and clarifications.

  • Legislative Drafting: Drafted trailer bills, policy briefs, and compliance-impact materials to address systemic issues in Medi-Cal operations and other healthcare programs.

Civil Litigation and Investigations

  • Healthcare Regulation Enforcement: Litigated healthcare provider and facility cases with the Office of the Attorney General, achieving strong resolution rates in enforcing state and federal laws.

  • Funding Recovery: Led efforts to recover misspent, misappropriated Medicare, Medicaid, and federal grant funds, assessing risks and implementing recovery protocols.

  • Cross-Agency Collaboration: Partnered with CMS, OCR, and other federal agencies to align Medi-Cal operations with HIPAA, Medicare, and Medicaid requirements.

Healthcare Operations and Financing

Financing and Rate Development

  • Reimbursement Expertise: Managed legal matters related to Medi-Cal reimbursement methodologies, drafting and advising on:

    • Fee-For-Service (FFS) Rates and Capitated Payment Structures for Managed Care Organizations.

    • Supplemental payment programs such as:

      • Quality Assurance Fee (QAF)

      • Disproportionate Share Hospital (DSH) Payments

      • Delivery System Reform Incentive Payment (DSRIP) Program

  • Waiver Programs and Methodologies:

  • Drafted and implemented methodologies for:

    • Section 1115(a) Demonstration Waivers (e.g., Global Payment Program, Low Income Health Program).

    • 1915(b)/(c) Waivers for managed care and home- and community-based services.

  • Compliance and Funding Alignment: Partnered with the DHCS finance team and the Department of Finance to align with CMS requirements, securing federal matching funds.

Contract and Insurance Management

  • Contract Development and Oversight:

  • Drafted and advised on agreements to support Medi-Cal operations, including:

    • Interagency Agreements (IA)

    • Business Associate Agreements (BAA)

    • Data Use Agreements (DUA)

    • Joint Powers Authority (JPA) Agreements

    • County Memoranda of Understanding (MOUs)

    • Standardized contract forms, including STD 213 (primary contract form used by California state agencies for agreements with external entities, including service providers, contractors, and other governmental agencies) and General Terms and Conditions (GTC) templates (boilerplate terms that apply to all contracts using the STD 213 form, outlining the general legal, administrative, and procedural requirements of agreement.)

  • Mergers and Acquisitions: Led legal assessments and drafted provisions for hospital mergers, acquisitions, and successor liability, mitigating risks associated with audits, overpayments, and funding disputes.

Regulations, Privacy, and Data Compliance

Privacy and Breach Management

  • HIPAA Compliance Leadership: Responded to HIPAA complaints, advised on IPA and PRA investigations, and developed agency-wide privacy protocols to safeguard PHI, PI, and CI.

  • Corrective Actions and Transparency: Addressed large-scale privacy breaches, implemented corrective actions, and ensured compliance with federal directives while balancing public transparency under the California Public Records Act.

Strategic Legal Leadership

  • Regulatory and Contractual Compliance: Supported audits, investigations, and regulatory filings related to Medi-Cal program operations, providing innovative strategies to ensure compliance and mitigate legal risks.

  • High-Stakes Governance: Oversaw complex legal matters, including safety net financing, federal and state reimbursement structures, and regulatory compliance across multiple stakeholders.

Cultural Competency and Advocacy

Inclusive Healthcare Advocacy

  • Equitable Access Initiatives: Promoted cultural competency in healthcare delivery, ensuring underserved communities received equitable care.

  • Language Proficiency: Leveraged Spanish proficiency to facilitate communication and improve access to healthcare for diverse populations.

  • Public Education and Thought Leadership: Delivered guest lectures on disability law and healthcare policy, showcasing leadership in advocating for equity and inclusion in healthcare.

Key Expertise and Strategic Partnerships

Key Areas of Expertise

  • Application of statutory frameworks to develop operational reforms and compliance strategies.

  • Leadership in policy advocacy, stakeholder engagement, and healthcare program implementation.

Strategic Partnerships

  • Federal Agencies:

    • Centers for Medicare and Medicaid Services (CMS)

    • Health and Human Services (HHS)

    • Office of Civil Rights (OCR)

  • State Entities:

    • California Department of Public Health (CDPH): Licensing, certification, and infection prevention.

    • Department of Managed Health Care (DMHC)

    • California Department of Insurance: Fraud investigations and oversight.

    • California Department of Industrial Relations: Implemented statutory protocols to suspend fraudulent Workers' Compensation providers, safeguarding public funds and protecting the public.

    • Office of the Attorney General: Health, Education, and Welfare Division.

  • Local and Regional Partners:

    • County health departments and District Offices

    • Local interagency councils for healthcare delivery.

Key Areas of Expertise

  • Expertise in applying statutory frameworks to develop compliance strategies and operational reforms.

  • Leadership in policy advocacy, stakeholder engagement, and government relations for California healthcare initiatives.

  • Direct knowledge and experience in key state entity law compliance: worked closely with the California Public Records Act, Political Reform Act, Bagley-Keene Open Meeting Act, and Government Claims Act, developing a strong understanding of legal requirements pertinent to public agencies and departments.

  • High-Stakes Contract and Insurance Management: Successfully managed contract and insurance reviews related to large hospital mergers, acquisitions, safety net financing, successor liability, reconciliation, audits, overpayments along with other critical legal matters, providing strategic guidance to minimize risk and ensure regulatory compliance.

Special Assistant to the Deputy Director and Chief Counsel
California Department of Health Care Services (DHCS), Sacramento, CA
2010–2011

  • Executive-Level Legal Analysis: Provided counsel on high-priority legislation, litigation, and legislative and government affairs affecting Californias public and private healthcare landscape, including tribal health Medi-Cal services. Advised DHCS Chief Counsel on regulatory amendments and prepared key reports for the Governor’s Office and DHCS Chief Counsel.

  • Legislative and Regulatory Analysis: Assisted DHCS Chief Counsel with legal interpretation of state and federal statutes affecting public health programs, including Medicare and Medicaid regulations. Provided strategic recommendations for program and policy alignment in response to regulatory changes.

  • Public Sector Policy Coordination: Collaborated with internal and external stakeholders on policy matters, including risk assessment, regulatory adherence, and public health initiatives. Engaged with the OIG and CMS representatives to ensure consistency in healthcare policy implementation across agencies.

PUBLICATIONS

  • “A Primary Care Provider’s Guide to Managing Respiratory Health in Subacute and Chronic Spinal Cord Injury”
    American Spinal Injury Association, Topics in Spinal Cord Injury Rehabilitation, Spring 2020

  • “Disability Reintegration”
    Training manual for UC Davis Medical Center Physical Medicine and Rehabilitation Residents, 2006

  • “Disabled Women’s Knowledge of Women with Disabilities Treatment From the Legal Community in Cases of Domestic Violence/Sexual Assault”
    Master’s Thesis, California State University, Sacramento, 2006

TEACHING & SPEAKING ENGAGEMENTS

Keynote Speaker, Wilderness Medicine Society (WMS) Winter Conference, Olympic Valley, CA
Pushing the Limits of Independence and performance in Outdoor Recreation, a Post Complex/ Injury/Illness Refresh for the Medical Community
February 2023

Australian and New Zealand Spinal Cord Society Annual Scientific Meeting
Lived experience - Ventilatory Dependent Spinal Cord Injury
October 2021

Guest Lecturer, UC Davis Medical Center, Sacramento, CA
Topics in Disability and Healthcare Law
2005–2006

INTERNSHIPS

Graduate Student Assistant and Summer Intern

California Department of Health Care Services (DHCS), Sacramento, CA
July 2007 – December 2008

Legal Research Law Clerk

California Office of Administrative Hearings, Sacramento, CA
July – November 2007

Conducted legal research and case preparation, supporting administrative hearing processes, drafted mock decisions

Hiring Team Consultant/Lobbyist
Protection and Advocacy, Inc. (now Disability Rights California), Sacramento, CA
2004–2005
Evaluated attorney candidates, advised on legislative proposals, and lobbied for disability rights advancements. Conducted legal research and drafted bill language, testified in committee, lobbied and met with legislators, their staff and committee chairs, advancing home and community-based waiver services ultimately adopted by California from HCFA (now CMS), administered by DHS (now DHCS), in the creation and implementation of private duty nursing care for adults aged out of EPSDT.

PROFESSIONAL AFFILIATIONS

American Case Management Association (ACMA)
National and Local Chapter Memberships

American Health Law Association (AHLA)
Member

American Spinal Injury Association
Committee Memberships
Diversity, Equity and Inclusion Taskforce (DEI), Communications Committee, Outreach Committee (Merger of Primary Care + Advocacy and Health Policy Committees)

California Society for Healthcare Attorneys (CSHA)

Committee Memberships
Education , Diversity, Equity and Inclusion (DEI) Taskforce

Institute for Healthcare Improvement (IHI)
 Member

Wilderness Medical Society (WMS)

Committee Membership
Justice Equity Diversity and Inclusion Committee (JEDI)

Association of Rehabilitation Nurses
 Member

LANGUAGES

  • Spanish: Fluent (speaking, reading, and writing)

    • Served as interpreter for inpatient and outpatient complex health system settings .

Contact Sara for:

Legal Services, Mentorship, Speaking Engagements, and more