Brett R. Friedman
Brett Friedman is a partner in the health care practice group of the corporate department. Since coming to Ropes & Gray, Brett has gained significant experience in advising clients on a variety of complex transactional, enforcement and regulatory matters within the health care industry. His clients have included hospitals, managed care plans, pharmacy and dental benefit managers, pharmaceutical and device manufacturers and community-based providers of care to individuals with mental illness and developmental disabilities.
Brett has particular experience counseling both payer and provider clients in responding to the transition to accountable care and value-based payment, including the development of provider risk-bearing organizations, Accountable Care Organizations (“ACOs”), independent practice associations (“IPAs”), and other integrated delivery networks. Brett also routinely advises clients in the course of government investigations, audits, and self-disclosures concerning potential violations of Medicare and Medicaid regulatory authorities and health care fraud and abuse laws. In addition, Brett’s transactional experience includes advising private equity, for-profit and tax-exempt clients regarding health care due diligence, regulatory and reimbursement issues.
Development of Integrated Delivery Networks
- Advising a multi-state proprietary health system in the expansion and implementation of its integrated care delivery model and population health strategy in Connecticut, Rhode Island and New Jersey.
- Representing a not-for-profit corporation in the successful formation of the first ACO in the New York region, serving primarily individuals with intellectual and developmental disabilities, and the ACO’s subsequent application to participate in the Medicare Shared Savings Program.
- Providing strategic counseling to a consortium of behavioral health providers seeking to leverage existing clinical integration activities into complementary service offerings capable of meeting the demands of value-based payment.
- Structuring the terms, including associated governance and participation rights, involving a multi-million dollar strategic investment into a health plan specifically formed to provide coverage to beneficiaries dually eligible for Medicare and Medicaid.
Health System Operations and Transactions
- Furnishing ongoing regulatory and transactional advice to large community hospitals and academic medical centers regarding both routine and non-routine compliance, enforcement and reimbursement issues arising out of hospital-physician relationships; internal compliance and billing matters; and physician practice acquisitions.
- Representing five providers in acquiring behavioral health and developmental disabilities programs Federation Employment & Guidance Services (FEGS) through the latter’s bankruptcy process.
Resolution of Investigations and Audits
- Representing a client in achieving the successful resolution of a high-profile fraud investigation conducted by the New York State Attorney General and the United States Attorney’s Office for the Southern District of New York into improper billing and cost reporting practices; negotiated one of the first New York State corporate integrity agreements (“CIAs”) with the Office of Inspector General for the United States Department of Health & Human Services (“OIG”) and the New York State Office of the Medicaid Inspector General (“OMIG”).
- Representing an academic medical center in the civil resolution of an eight- year investigation into its historical financial relationship with over 20 physician practice groups for compliance with the Stark Law and federal Anti-Kickback Statute.
Pharmaceutical, Health Plan and Provider Compliance
- Counseling a large pharmaceutical manufacturer on the application of federal and state anti-kickback laws and FDA regulatory authorities on promotional activities and other interactions with health care professionals, including as part of a seven-month secondment to its in-house legal department.
- Conducting numerous compliance program reviews and risk assessments for providers, managed care plans and academic medical centers with the objective of enhancing the effectiveness of health care compliance program activities to meet obligations under OIG and OMIG CIAs, continually evolving legal standards and industry best practices.
- Co-author, “Health Care Mergers and Acquisitions: The Transactional Perspective,” Bloomberg BNA Health Law & Business Series Portfolio 2100 (2nd edition) (2017)
- AHLA Summary of OIG Advisory Opinion 15-17; AHLA Summary of OIG Advisory Opinion 15-07 (June 4, 2015); and AHLA Summary of OIG Advisory Opinion 15-02 (March 30, 2015)
- Ann E. Lewis & Brett R. Friedman, “Thou Shalt Not Buy Business: The Implications of the Anti-Kickback Statute for the Drug and Device Industry,” The Health Care Law Handbook: A Comprehensive Overview of the Laws, Regulations and Enforcement Landscape for Health Care Compliance Professionals in Pharmaceutical and Medical Device Companies (Seton Hall Law & Am. Health Lawyers Ass’n eds., Summer 2012)
- Brett R. Friedman, “OIG Issues Alert Cautioning Physicians on the Consequences of Reassignment of Their Medicare Payments,” American Health Lawyers Association Alert (February 2012)
- Co-Presenter, “Mergers & Acquisitions, and Program Closings: Due Diligence, Risk and Compliance Program Considerations,” The Bonadio Group’s 10th Annual Compliance Program Development Series (December 13, 2017)
- Presenter and Panelist, “Value-Based Payment: Legal and Contracting Perspectives for IPAs, ACOs and BHCCs,” New York State VBP Networking Series: New York City and Long Island Regional Sessions (June 7, 2017 & June 14, 2017)
- Presenter, “Behavioral Health Value-Based Payment Readiness: Key Considerations for Participation in IPAs and BHCCs,” Statewide Webinar from OMH, OASAS and MCTAC (June 1, 2017)
- Panelist, “The New Partnership Paradigm in Integrated Behavioral Health,” 2017 Annual Conference: NYS Coalition for Behavioral Health (March 30, 2017)
- Co-Presenter, “Provider Risk-Bearing Organizations: Opportunities and Challenges in the Transition to Value-Based Health Care,” IPMI 2017 Healthcare Law & Compliance Institute (March 6, 2017)
- Moderator, “Population Health & Transitioning to Value-Based Care,” YJP CEO Healthcare Symposium (February 16, 2017)
- Speaker, “Tips and Tricks for Managing the Unique Elements of Health Care Transactions,” Bloomberg BNA Webinar (October 5, 2016)
- Co-Presenter, “Antitrust Considerations in Health Care; New York’s Delivery System Reform Incentive Payment (DSRIP) Program,” Greater New York Hospital Association (July 29, 2015)
- Co-Presenter, “CIAs in the Pharmacy Sector,” American Society for Pharmacy Law – Developments in Pharmacy Law Seminar (November 8, 2014)
- Co-Presenter, “What Should CIAs Be Telling Me? Using Recent Corporate Integrity Agreements to Inform and Assess your Compliance Program’s Effectiveness,” Ropes & Gray client teleconference (January 14, 2014)
- Co-Presenter, “Effective Negotiation of Pharmaceutical, Provider and Health Plan Corporate Integrity Agreements,” HFMA First Illinois Chapter Compliance Program (March 14, 2013)
- Presenter, “The Federal Anti-Kickback Statute and Regulatory Safe Harbors,” Ropes & Gray Health Care Boot Camp (2011-2013)