 |
|
Biography
Dennis' principal area of practice is in the health industry, and focuses on health care clients, with an emphasis on Medicare payment and compliance issues. He has represented providers in numerous cases before the Provider Reimbursement Review Board, Administrative Law Judges and the federal courts. He also advises clients on specific compliance questions and has worked with providers in establishing compliance programs. He has been involved in defending a number of cases arising under the False Claims Act.
|
|
|
Representative
Experience
- Prepared position paper and persuaded CMS officials to issue policy statement stating that discounts for any uninsured patient without regard to the patient's financial status will not affect Medicare payment
- Obtained decisions from CMS Central Office, CMS Regional Offices and ALJ in five separate instances reversing denials of provider-based status for hospital clinics; in each instance, more than $1 million was in controversy and in one instance, the amount at risk was $19 million a year
- On behalf of a children's hospital, convinced HRSA to reverse proposed substantial reductions in the FTE resident count for purposes of CHGME payments for residents assigned to research buildings
- Together with my partner, Bill Lawler, represented an academic medical center in a qui tam case on Medicare cost reporting fraud allegations in which the government had intervened and negotiated a settlement in the amount of approximately $12 million that was only 20 percent greater than the approximately $10 million in single damages
- Represented academic medical center in false claims investigation that was resolved by reopening prior year cost reports resulting in the client's receiving additional reimbursement greater than the amount of the settlement
- Represented a faculty practice plan in a PATH investigation where the Department of Justice declined a referral from the Office of the Inspector General's office for treatment as a False Claims Act matter and subsequently the Office of the Inspector General itself declined to proceed under its civil money penalty authority
- Obtained decision for a faculty practice plan reversing in its entirety a determination of a Medicare overpayment in the amount of $2.7 million
- Represented a durable medical equipment supplier in challenging an audit from which the results of a sample were extrapolated and relied upon to support recoupment of more than $1.2 million; the carrier fair hearing officer rejected the carrier's statistical methodology in its entirety, and ruled in favor of the supplier on all but $7,000
- Handled disclosure of extensive fraudulent conduct by a hospital's CEO with no adverse consequences to the hospital except repayment of overpayments
- Drafted position paper and participated in extensive dialogue with Health Care Financing Administration officials regarding referrals by hospital-compensated physicians to hospital-based home health agencies; HCFA subsequently reversed itself and made such referrals permissible
- Drafted comments on home health per beneficiary limitation proposed rule; HCFA reversed itself on applying the national average per beneficiary amount to home health agencies acquired by hospitals after their base year, an issue worth millions to individual hospitals, and one of very few changes made to the per beneficiary limitation rule
- Drafted rulemaking comments that convinced HCFA to reverse itself on treating nursing facilities as not having a base year for purposes of the prospective payment rates when the facility had a "13-month" cost reporting period beginning before the base year and ending afterwards; again, this was one of very few comments that resulted in a substantive change in the final rule
- Prevailed on appeal to the 8th Circuit in University of Iowa Hospitals and Clinics v. Shalala, where HCFA disallowed costs on grounds of inadequate documentation absent any published policy putting the provider on notice that such documentation was required
- Represented mental health provider and convinced an Assistant United States Attorney not to pursue a False Claims Act case against a provider when a HCFA audit found that all audited cases were erroneously paid
- Successfully represented Harris County Hospital District in the first case arising under 1987–1989 amendments to Medicare legislation on the allowability of bad debts claimed in accordance with policies previously accepted by Medicare intermediaries; Harris County Hosp. Dist. v. Shalala, 64 F.3d 220 (5th Cir. 1995)
- Successfully represented a group of more than 70 hospitals in contesting Medicare policy for computing inpatient average routine per diem cost, known as the "labor room day policy"; St. Mary of Nazareth Hosp. & Med. Ctr. v. Heckler, 760 F.3d 1311 (D.C. Cir. 1985)
|
| Results depend upon the facts of each case. |
|
Activities and Affiliations
- Editor/Principal Author: Dennis Barry's Reimbursement Advisor, monthly newsletter published by Aspen Publishers
- Listed: The Best Lawyers in America in health care law, 2005 and 2006; Chambers USA: America's Leading Business Lawyers in healthcare law, 2005-2006; "Best Lawyers in America: Health Care Law," Corporate Counsel, April 2004; one of ten "Outstanding Hospital Lawyers," Nightingale's Healthcare News
- Co-Chair: AHLA's annual 3-day Institute on Medicare & Medicaid Payment Issues
- Recipient: Founder's Medal of Honor, Muncie Gold Merit Award, Reeves Silver Merit Award, and Follmer Bronze Merit Award by the Healthcare Financial Management Association; 2004/2005 HFMA Best Article Award for outstanding contributions to the professional literature in Healthcare Financial Management
- Member: Healthcare Financial Management Association (HFMA), past president of Washington Metro chapter; American Health Lawyers Association
- Faculty: HFMA seminar series Developing Advanced Strategies for Health Care Reimbursement (1991-2000)
- Author: Chapter on cost reimbursement in Health Law Practice Guide, sponsored by the American Health Lawyers Association and published by West Group; Chapter on legal issues arising from relationships between hospitals and physicians in a book sponsored by the ABA Health Law Section, published by BNA in 2002
- Presentations: Dozens annually to conferences sponsored by the Healthcare Financial Management Association; Association of American Medical Colleges; American Health Lawyers Association; The American Institute of Certified Public Accountants, and other organizations
|
|
Education and Professional Background
- Ohio Wesleyan University, B.A. in economics, 1972 (Phi Beta Kappa)
- University of Virginia School of Law, J.D., 1975 (Co-editor, Virginia Journal of International Law)
- Admitted to practice: District of Columbia, 1984; United States Supreme Court; U.S. Court of Appeals for the Third, Fifth, Seventh, Eighth, Tenth, and District of Columbia Circuits; Federal District Court for the District of Columbia
|
