Profile

  • New York State Bar Association, Chair, Health Law Section; Chair, Committee on E-Health & Information Systems; Past Chair, Committee on Long Term Care
  • National Health Lawyer’s Association

1992 – 2014 Provider-Side Representation Exclusively Limited to Health & Long Term Care

  • Representation of institutional providers in audits, investigations, and rate litigation matters.
  • Representation of providers in compliance matters, internal investigations and external audits/self disclosure reviews.
  • Management of complex litigation/internal reviews/counseling; examples include school-based Medicaid in Education programs; county and statewide cost recovery projects; OMH/OASAS/OPWDD reviews; TPL reimbursement litigation; federal/state criminal investigations and false claims matters.
  • General Counsel to long term institutions.


1984 – 1992 New York State Medicaid Agency

  • Represented Medicaid audit staff in overpayment and fraud investigations.
  • Represented agency in civil rights defense litigation, contempt matters and bankruptcy proceedings in conjunction with Attorney General’s staff; developed legal analysis and strategy ultimately adopted by the Federal courts in provider terminations, disenrollment and withholding of payments.
  • Coordinated fraud and recovery efforts with the Attorney General’s Medicaid Fraud Control Unit and US Attorney’s Office.
  • Coordinated litigation against the Federal Department of Health and Human Services to enforce Medicare Maximization Project.
  • Conducted training of in-house attorneys on hearings and overpayment collection procedures; Developed internal training guides and overviews for audit procedures and litigation support.
  • Developed legal standards for settlements and filing of judgments.
  • Drafted law and regulations involving exclusion of providers, overpayment recoveries and financial security.
  • Developed of legal and financial analysis to support State-wide Medicaid audits and reviews for all provider types within the largest single payor system in the country – NYS Medicaid.
     

Representative Matters

  • Obtained precedent setting injunction preventing MFCU from prosecuting non-profit home care agency in false claims investigation. Secured dismissal of indictments.
  • Obtained precedent setting order allowing presence of corporate counsel in Attorney General depositions of management employees under Executive Law §63.13 investigation.
  • Represented external auditor appointed by the court to review target of false claims action in Brooklyn Adult Day Health Care Program litigation – ultimately resolved by guilty plea and $25 million in restitution.
  • Obtained precedent setting order invalidating LTC survey findings in Niagara County Supreme Court and obtained decision overturning CMS substantial compliance in immediate jeopardy situation before the Federal Departmental Appeals Board.
  • Resolved numerous audits conducted by MFCU’s Special Projects Unit involving cost audits of CHHAs, LTHHCPs as well as other focused reviews organized by the MFCU and OMIG.
  • Resolved numerous rate appeals and rate litigation matters involving all aspects of capital and operating rate deficiencies.

  • Hot Topics in LTC for Nursing Facilities, New York Association of Longterm Care Administrators Conference, October 18, 2019
  • As chair of the Health Law Section, delivered welcoming remarks and introduction, 2017 New York State Bar Association Health Law Section Annual Meeting, January 25, 2017
  • Health IT Update: Key Impediments to HITECH Implementation and the View Towards 2017, Albany Law School, January 23, 2017
  • Moderator, Payment Responsibilities in Public Programs: Medicaid Managed Care, New York State Bar Association Health Law Section Fall Meeting, October 30, 2015
  • Diversity in Health Care & Legal Representation, Affordable Care Act and Readiness for 2014 and Beyond, NYSBA Health Section Fall Conference, October 25, 2013
  • Bond Webinar, HITECH and HIPAA Omnibus Final Rule - A Glimpse at Primary Changes, September 23, 2013
  • Financial Managers Conference
  • Foundation for Accounting Education
  • Institute for Health and Human Services
  • New York Association of Homes and Services for the Aging Compliance Roundtable Forums
  • New York State Bar Association
  • New York State Health Care Providers Association
  • Albany Law School

  • “Telehealth & Telemedicine Reimbursement Issues,” NYSBA Health Law Journal, 2015