- Health Care Fraud Strike Force
|University ||Queens College, B.A., 1979|
|Law School||Georgetown University Law Center, J.D., 1984|
|Admitted||1985, New York; 1987, U.S. District Court, Eastern and Southern Districts of New York; 1988, U.S. Court of Appeals, Second Circuit; 1997, U.S. Court of Appeals, Fourth Circuit|
Brian McGovern provides legal counsel and representation to health care and not-for-profit clients. His knowledge and experience span the breadth of legal issues that confront the provider community, including counseling health care providers and managed care plans on regulatory compliance; responding to government audits and investigations, including Medicare fiscal intermediary audits and New York State Office of Medicaid Inspector General (OMIG) and Attorney General Medicaid Fraud Control Unit (MFCU) inquiries; advising on and negotiating managed care, vendor, and other contracts; providing counsel and advocacy on reimbursement issues; assisting providers on administrative applications and matters before regulatory agencies, including rate appeals, certificate of need applications, and property tax exemption applications and appeals; responding to patient-care survey deficiency citations; and representing providers in administrative hearings and litigation in State and Federal courts. The providers represented during his career at Cadwalader include nursing homes, home care agencies, hospices, hospitals, continuing care retirement communities, pediatric facilities and managed care plans.
Brian has also counseled provider associations on statutory, regulatory and other legal developments impacting long term care providers in New York State. Brian has given lectures and presentations to the health care industry on topics ranging from corporate compliance, False Claims Act and fraud and abuse investigations and prosecutions, OMIG and MFCU audit initiatives, managed care contracting, and real property tax exemption.
Before coming to Cadwalader, Brian served for five and one-half years as an Assistant Attorney General for New York State, where he defended the State in, among other matters, Medicaid reimbursement litigation and other legal challenges to statutes, regulations, and agency actions affecting health care providers.
Brian graduated from Georgetown University Law Center. He is admitted to practice in New York State, the U.S. District Courts for the Southern and Eastern Districts of New York, and the U.S. Courts of Appeals for the Second and Fourth Circuits. Brian is listed in The Best Lawyers in America.
News & Resources
• Cadwalader Honored By Legal Aid Society With 2015 Pro Bono Publico Award Nov 10, 2015
• Courts Side With Relators in Big Cases, but Some Get Slapped Back Aug 03, 2015
• Cadwalader Recognized in 2016 Edition of The Best Lawyers in America Aug 17, 2015
Clients & Friends Memos
• Budget Legislation Repeals Affordable Care Act's Automatic Enrollment Requirement for Large Employers Nov 05, 2015
• Sounding The D&O Liability Alarm For Health Nonprofits Mar 03, 2015
• Health Care Industry Enforcement: Significant False Claims Act and Related Developments Jul 27, 2015
Documents by this lawyer on Martindale.com
Pharmaceutical Manufacturer's Preemptive Suit Secures Preliminary First Amendment Protection for Script to Promote Off-Label Use
Aaron Buchman,Bret A. Campbell,Adam S. Lurie,Brian T. McGovern,Martin L. Seidel, August 19, 2015
On August 7, 2015, the U.S. District Court for the Southern District of New York invoked the First Amendment, granting Amarin Pharma, Inc. (Amarin) preliminary protection against federal criminal prosecution for misbranding and allowing Amarin to promote its drug, Vascepa, for off-label use through...
In Closely Watched Case, Federal Court Upholds the Government’s Position on Provider Mandate to Report and Return Medicare and Medicaid Overpayments in 60 Days
Jared Facher,Brian T. McGovern, August 11, 2015
The Patient Protection and Affordable Care Act (“PPACA”), signed into law on March 23, 2010, included a provision (the “Report and Refund Mandate”), broadly requiring health care providers, suppliers, Part D plans and managed care organizations that were overpaid by the...
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