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Primary Care Providers Win Challenge of CMS Interpretation of Enhanced Payment Law

With the help and support of the Tennessee Medical Association, 21 Tennessee physicians of underserved communities joined together and retained Bass, Berry & Sims to file suit against the Centers for Medicare & Medicaid Services to stop improper collection efforts. Our team, led by David King, was successful in halting efforts to recoup TennCare payments that were used legitimately to expand services in communities that needed them. Read more

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GDPR Top 5 Actions You Should Take Now

The EU's General Data Protection Regulation (GDPR) went into effect on May 25th. As most organizations are aware, the GDPR applies not only to EU businesses but also many companies in the U.S. While the deadline is quickly approaching, most organizations are still grappling with the implications of the regulation on their business. Even if your readiness efforts are behind the curve, the GDPR Top 5 Actions You Should Take NOW will help you begin your efforts towards compliance and help mitigate your organization's risk in the short-term.

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Brian D. Bewley

Member

Nashville
(615) 742-7888 TEL
(615) 742-7888 FAX

Brian D. Bewley

Member

Nashville
(615) 742-7888 TEL
(615) 742-7888 FAX
Nashville
(615) 742-7888 TEL
(615) 742-7888 FAX

Leveraging his years of experience working in the healthcare fraud divisions at the Office of Inspector General for the Department of Health and Human Services (HHS-OIG) and the Department of Justice (DOJ), Brian Bewley assists healthcare clients related to the enforcement of and compliance with regulatory statutes. He helps clients navigate civil, criminal and administrative matters brought by whistleblowers and the federal government, including those under the False Claims Act (FCA), the Stark Law and the Anti-Kickback Statute (AKS). In addition to major compliance issues, Brian also counsels clients with respect to daily operational issues, joint venture structuring, private equity acquisitions and other business transactions.

Brian works with legal departments and corporate leaders from a wide range of healthcare entities, including hospitals and health systems, medical device companies, home health providers, hospice organizations, ambulatory services, post-acute care, specialty-pharmacies and other specialized providers.

Leveraging his years of experience working in the healthcare fraud divisions at the Office of Inspector General for the Department of Health and Human Services (HHS-OIG) and the Department of Justice (DOJ), Brian Bewley assists healthcare clients related to the enforcement of and compliance with regulatory statutes. He helps clients navigate civil, criminal and administrative matters brought by whistleblowers and the federal government, including those under the False Claims Act (FCA), the Stark Law and the Anti-Kickback Statute (AKS). In addition to major compliance issues, Brian also counsels clients with respect to daily operational issues, joint venture structuring, private equity acquisitions and other business transactions.

Brian works with legal departments and corporate leaders from a wide range of healthcare entities, including hospitals and health systems, medical device companies, home health providers, hospice organizations, ambulatory services, post-acute care, specialty-pharmacies and other specialized providers. His practice includes:

  • Healthcare Contracting, Regulatory & Operational – Counseling and leading internal investigations related to the various state and federal regulatory requirements in connection with the day-to-day operational challenges of healthcare providers and suppliers, including billing and reimbursement, arrangements with referrals sources, research funded by federal monies, Corporate Integrity Agreements (CIAs); conducting compliance program effectiveness reviews of healthcare providers and more.
  • Healthcare Mergers, Acquisitions & Dispositions – Providing regulatory counsel to buyers and sellers in healthcare transactions on complex compliance and operational considerations, including compliant joint venture structures, successor liability, pre-closing compliance resolution, post-closing disputes, and voluntary disclosures.
  • Healthcare Fraud & Abuse – Representing for-profit and not-for-profit healthcare companies in fraud and abuse investigations, enforcement actions and litigation stemming from government and whistleblower claims brought under the FCA, the AKS, the Stark Law, Medicare and Medicaid reimbursement rules, and various other federal and state healthcare statutes and regulations.

Prior to joining Bass, Berry & Sims, Brian was the co-practice leader of the Compliance and Government Audit and Investigations practice areas at an AmLaw 100 firm. Brian previously served as Senior Counsel at the HHS-OIG, where he was team leader for the Boston, Miami, Dallas and San Francisco regions. Brian was also appointed Special Assistant U.S. Attorney for the DOJ by a former U.S. Attorney and current federal judge. In both roles, Brian represented the government in matters brought under the FCA, AKS, Stark Law, Medicare and Medicaid reimbursement rules and off-label marketing, with many of these cases producing multi-million dollar settlements.

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Memberships

Health Care Compliance Association – Midwest Region Conference, Program Chair (2013-2017)

American Health Lawyers Association (AHLA) – Fraud & Abuse Practice Group, Advisory Opinion Task Force

American Bar Association – Health Law Practice Group

News

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Publications

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Media Mentions

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Additional Thought Leadership

Speaking Engagements

  • "Use of the Travel Act in Prosecutions of Healthcare Fraud," 15th Annual American Bar Association (ABA) Washington Health Law Summit (December 2017)
  • "Health Care Compliance Issues – Year in Review," Health Care Compliance Association (HCCA) Kansas City Regional Conference (September 2017)
  • "The Business of Health Care Fraud Enforcement: A Pragmatic Discussion and Assessment," Health Care Compliance Association (HCCA) 21st Annual Compliance Institute (March 2017)
  • "Hot Topics in Healthcare Fraud and Abuse," Tennessee Society of Certified Public Accountants (TSCPA) Health Care Conference (November 2016)
  • "Fraud and Abuse – Year in Review," Health Care Compliance Association (HCCA) web conference (January 2016)
  • "Responding to a Government Investigation: Best Practices for Achieving a Favorable Outcome," Health Care Compliance Association (HCCA) Compliance Institute (March 2014)
  • "Hone in on Home and Hospice Compliance and Quality: The Government Is Watching," American Health Lawyers Association (AHLA) Long-Term Care and the Law Conference (February 2014)
  • "Marketing/Anti-kickback Issues in Healthcare – So What Are the Rules These Days?," American Health Lawyers Association (AHLA) webinar (February 2014)
  • "Risk Areas for Hospice Providers – OIG Enforcement Initiatives," Colorado Center for Hospice & Palliative Care 2013 Fall Conference (October 2013)

Accolades

Nashville Medical News – "InCharge Healthcare" (2017)

Super Lawyers – "Rising Star" (2014)

Inspector General Exceptional Achievement Award (2009-2012)

U.S. Attorney General Honors Attorney (2004)

Washington University Law Review – Executive Notes Editor

Representative Experience:

  • Successfully defended large for-profit skilled nursing and rehabilitation providers in aggressive 5-year investigation pertaining to alleged medically unnecessary occupational, physical, and speech therapy services. After successfully persuading the Department of Justice (DOJ) not to pursue criminal indictments, secured a civil False Claims Act (FCA) settlement for $8.3 million with DOJ and Office of Inspector General (OIG) – a substantial decrease from the government's initial offer.
  • Represented Missouri skilled nursing provider during district court and appellate proceedings in a False Claims Act (FCA) lawsuit alleging violations of the Anti-Kickback Statute (AKS). Successfully obtained dismissal of relator's complaint based on the FCA's public disclosure bar. United States ex rel. Bogina v. Medline Indus., Inc., No. 11 C 05373, 2015 WL 1396190 (N.D. Ill. Mar. 24, 2015), aff'd sub nom. U.S. ex rel. Bogina v. Medline Indus., Inc., 809 F.3d 365 (7th Cir. 2016).
  • Represented a hospice seller in complex post-sale dispute with private-equity backed national hospice company. After buyer self-disclosed to OIG, and sued client in arbitration for proposed settlement amount with OIG, persuaded OIG that its client was party-of-interest and negotiated final resolution with OIG for almost $10 million less than originally proposed.
  • Defended hospice organization in litigation under the False Claims Act (FCA). After filing motion to dismiss on 9(b) and 12(b)(6) grounds, Relator voluntarily dismissed complaint. 
  • Successfully defended specialty pharmacy organization in federal investigation. After presenting rebuttal information and defenses, the government closed its investigation.
  • Successfully represented large national ambulance company in a False Claims Act (FCA) investigation by the Department of Justice (DOJ) and Office of Inspector General (OIG). After making multiple presentations to the government that the conduct at issue did not rise to the level of a "false claim," the government closed its investigation.
  • Represented health system in voluntary disclosure to the Office of Inspector General (OIG) involving employment of an excluded individual. Importantly, Representation included obtaining a monetary settlement with the system's vendor for the total amount paid to the government pursuant to the disclosure and all associated legal fees.
  • Successfully represented health system in qui tam action alleging false claims based on provider-based billing and 340B. After making presentations to the government, Department of Justice (DOJ) declined to intervene and Relator agreed to dismiss the matter without prejudice.
  • On behalf of health system, conducted internal investigation of alleged compliance issue. Internal investigation concluded that allegations by a former employee lacked merit.
  • Represented multiple large health systems in voluntary disclosures to the Office of Inspector General (OIG) for alleged violations of the civil monetary penalties law. Obtained settlements in less than nine months after the initial disclosures and without the OIG challenging the health systems' theories of liability or assessments of harm.
  • Represented health system in the successful acquisition of a hospital by conducting a comprehensive regulatory due diligence of the acquired hospital.
  • Engaged by board of directors of national Pharmacy Benefit Manager to conduct a robust and complicated internal investigation into alleged violations of several federal laws.
  • Represented numerous entities operating under Corporate Integrity Agreements with HHS-OIG, including with evaluating potential non-compliance for purposes of assessing reporting requirements and the impact of successor liability in proposed mergers and acquisitions.

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