Kyle
Gotchy

Represented health systems, medical groups, clinical laboratories, and individual physicians in various stages of government investigation by the U.S. Department of Justice, state Medicaid Fraud Control Units, and other law enforcement agencies

Counseled multinational technology company on a range of issues in connection with the development and implementation of a market leading telehealth service, including scope of practice, professional licensure, reimbursement, prescriptive practice, and patient engagement

Represented multiple health systems on the establishment and expansion of multistate telemedicine programs

Representing health system in administrative appeal of Medicare overpayment determination based on adverse findings in a HHS OIG hospital audit report, focused primarily on billing requirements for inpatient rehabilitation facility services

Represented multiple health systems and other providers in investigating and self-disclosing potential overpayments to CMS under the Self-Referral Disclosure Protocol (SRDP)

Represented multiple health systems and providers in responding to investigations by professional licensing boards

Counseled health system on the development of a co-management arrangement with a behavioral health hospital for an eating disorder treatment program

Advised private equity firms on the legal and business risks in connection with complex healthcare industry acquisitions

Advised health system on issues raised under the federal anti-kickback statute and physician self-referral law in connection with a high-profile contract dispute with specialty group

Counseled multiple manufacturers regarding compliance with reporting obligations under the federal Physician Payments Sunshine Act

Counseled health system on the development of a cardiology co-management arrangement

Represented academic medical center and physician in appealing proposed revocation of Medicare billing privileges

Advised concierge medical practice on the development of a telemedicine service

Represented coalition of clients in the development and submission of comments to CMS and HHS OIG in response to proposed rules amending the federal anti-kickback statute, the civil monetary penalties law, and the physician self-referral (Stark) law

Counseled health systems and other providers on compliance with CARES Act and Provider Relief Fund requirements

Advised multiple health systems on the development of a range of physician alignment models

Counseled hospitals, medical groups, and clinical laboratories on collateral issues raised by the exclusion of practitioners from federal heath care programs

Counseled multiple clinically integrated networks and accountable care organizations located across the country on structuring financial relationships consistently with federal and state fraud and abuse laws and related rules governing participation in Medicare value-based payment programs

Counseled executive leadership and board of skilled nursing facility regarding resident rights and community engagement

Represented health system in negotiations with academic medical center regarding staffing arrangement in support of air transport service