Associate - Healthcare

JOB SUMMARY:

Foley Hoag’s Healthcare Department is seeking a highly qualified attorney to join our nationally recognized practice. Candidates will have a minimum of three to four years of experience in the Medicare, Medicaid, and/or 340B drug pricing space, with the ability to support other healthcare matters.

DUTIES/RESPONSIBILITIES:

Experienced attorney will represent clients from across the health care industry, including, in particular, providers in the life sciences sector (such as pharmaceutical, biological and medical device manufacturers), health care providers such as hospitals, physician group practices, clinical laboratories, dialysis providers, home health agencies and long-term care providers, and investors in the foregoing. Candidate will routinely provide advice on the Medicare and Medicaid coverage, coding and reimbursement process. The candidate must be familiar with the rules governing Medicare and Medicaid and have a strong understanding of administrative law.  Familiarity with compliance with complex regulatory requirements applicable to the healthcare and life sciences industries, including the United States organ procurement process, is also important.

Required Skills/Abilities:

The ideal candidate will have at least three years of experience working with healthcare and/or life sciences clients on compliance issues with a solid working knowledge of the Medicare and Medicaid regulatory regime including the Medicare coverage and coding process as well as the program’s payment systems, the Medicare Advantage program, the 340B program, and the Inflation Reduction Act’s drug negotiation provisions.  Familiarity with the programs’ compliance regime including the Anti-Kickback Statute, Physician Self-Referral (Stark) Law, False Claims Act, and other fraud and abuse laws and regulations are also important.  Experience related to the Medicare appeals process and familiarity with the U.S. Department of Health and Human Services Departmental Appeals Board is a plus, as is preparing responses to information demands from the HHS Office of Inspector General (OIG) and U.S. Department of Justice (DOJ).

Background:

Excellent academic credentials and a J.D. degree from an accredited law school or equivalent are required. Experience at a relevant government agency, such as the HHS OIG, CMS Division of Technical Payment Policy, HHS Office of the General Counsel, or U.S. DOJ is a plus.