Melissa Pifko, vice president and chief legal officer for health care and clinical affairs at The University of Texas Health Science Center at Houston. Courtesy photo

Covering corporate law depart­ments and in-house attorneys for Texas Lawyer and other ALM publications, reporter Kristen Rasmussen profiles Melissa Pifko, vice president and chief legal officer for health care and clinical affairs at The University of Texas Health Science Center at Houston. UTHealth’s legal department is unique in that it is overseen by two top attorneys—Pifko and her colleague, Daniel Reat, vice president and chief legal officer for operations and business affairs, who was featured in this series in the May edition of Texas Lawyer.

UTHealth is the most comprehensive academic health center in the UT System and the U.S. Gulf Coast region. It includes schools of biomedical informatics, biomedical sciences, dentistry, nursing, public health and the John P. and Kathrine G. McGovern Medical School ­(formerly UTHealth Medical School). UTHealth also includes The University of Texas Harris County Psychiatric Center and a growing network of medical clinics throughout Houston and the region, as well as a robust research component that attracts physicians and scientists from around the world. UTHealth’s primary teaching hospitals are Memorial Hermann-Texas Medical Center, Children’s Memorial Hermann Hospital and Harris Health System’s Lyndon B. Johnson Hospital.


The UTHealth legal department is made up of seven attorneys, a health care risk manager and four support staff members. Each attorney generally handles discrete specialty areas, but all sometimes work as generalists, and all report dually to both CLOs.The department’s two-CLO model is new, implemented in January when Pifko arrived after a national search yielded two finalists. (Reat became UTHealth’s interim CLO in April 2016 and co-CLO last December.)

“Daniel and I have complementary practice areas, with my background in health care law and his in operational matters,” Pifko says, adding that due to his stint as interim-CLO, Reat has been able to “offer a lot of history about the office, clients and ongoing projects, which has made for a smooth transition.”


Pifko says that most of the day-to-day work, such as preparation of various contracts, is handled in-house, although the department outsources some work. For health care transactional and regulatory matters, it typically uses BakerHostetler and King & Spalding. For professional liability matters, the department turns to a handful of smaller law firms, in consultation with the UT System Office of General Counsel and the state Attorney General’s Office. John Strawn of Strawn Pickens recently argued a professional liability case involving governmental immunity under the Texas Tort Claims Act before the Texas Supreme Court. And Norton Rose Fulbright currently is working on a companion case.


Pifko is responsible for legal matters associated with the university’s role as a healthcare institution, including UTHealth’s academic affiliations with Memorial Hermann and Harris Health, legal issues involving its faculty members’ provision of healthcare services to patients, coordinating with its risk manager, who is a registered nurse, and collaborating with co-CLO Reat.

In addition, Pifko says she always has her eye on the federal Stark Law, which governs physician self-referrals, as well as the federal Anti-Kickback Statute. She also works with UTHealth’s privacy officer on compliance with the Health Insurance Portability and Accountability Act.

“I love to strategize and develop creative, legally compliant ways to structure transactions,” Pifko says.


After graduating from the University of Southern California School of Law, Pifko, at the suggestion of her ­professor and ­constitutional law guru Erwin Chemerinsky, clerked for Judge Lynn Hughes of the U.S. District Court for the Southern District of Texas in Houston—a position Pifko describes as “an incomparable (and fun) learning experience.”

She then returned to her hometown of Los Angeles, where she was an associate for several years at Latham & Watkins before moving back to Houston to work as an associate, senior associate, counsel and senior counsel specializing in health care law at Fulbright & Jaworski (now Norton Rose Fulbright).

In 2011, Pifko became associate GC at Baylor College of Medicine, where she worked on a variety of practice areas, including a trip to Malawi and Botswana to negotiate contracts with those governments.

She joined UTHealth as its co-CLO in January.

“It was a natural transition [from Baylor] because both institutions share a similar history of having medical schools but not owning or operating their own hospitals, which is relatively unique in academic medicine,” Pifko says.


Pifko says she enjoys volunteering in her children’s school, watching her son’s soccer and Little League baseball games and embracing her daughter’s humor and creativity. She also loves exercising, namely tennis, Pilates and spinning.


Pilko says her most recent books are: “A Gentleman in Moscow” by Amor Towles, a novel about a man ordered to spend the rest of his life in a luxury hotel; “Hillbilly Elegy,” by J.D. Vance, a former Marine and Yale Law School graduate’s memoir of growing up in a poor Rust Belt town and analysis of the struggles of America’s white working class; and “There Are No Children Here” by Alex Kotlowitz, a true account of two boys struggling to survive in a Chicago public housing complex marred by crime and neglect.