- 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
• Regulations Limiting Executive Compensation and Administrative Costs of State-Funded Providers Upheld by Appellate Division, Second Department Dec 31, 2015
• 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 Nov 16, 2015
• Health Care Industry Enforcement: Significant False Claims Act and Related Developments Jul 27, 2015
Documents by this lawyer on Martindale.com
Regulations Limiting Executive Compensation and Administrative Costs of State-Funded Providers Upheld by Appellate Division, Second Department
Christina T. Holder,Pamela Landman,Brian T. McGovern, January 18, 2016
On December 30, 2015, the New York State Appellate Division, Second Department issued a decision in Agencies for Children’s Therapy Servs., Inc. v. N.Y. St. Dep’t of Health,1 upholding the regulations promulgated by the Department of Health (“DOH”) pursuant to Executive...
The End of the Implied Certification Theory?: The U.S. Supreme Court Grants Certiorari in Case That Could Substantially Limit the False Claims Act
Jonathan Bailyn,Keith M. Gerver,Adam S. Lurie,Brian T. McGovern,Anne M. Tompkins, December 28, 2015
On December 4, 2015, the United States Supreme Court granted certiorari in Universal Health Services, Inc. v. United States ex rel. Escobar. In Universal Health Services, Inc., the Supreme Court will decide the legal validity of the “implied certification” theory of False Claims Act...
Albany County Supreme Court Upholds $199,000 “Hard Cap” on State Funded Executive Compensation, While Striking “Soft Cap” on Funding From All Sources
Christina T. Holder,Pamela Landman,Brian T. McGovern, November 30, 2015
On November 13, 2015, the New York State Supreme Court, Albany County issued a decision in LeadingAge et al. v. Shah,1 upholding in part and invalidating in part regulations issued by the Department of Health to implement Executive Order 38, limiting executive compensation and administrative...
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