Lauren M. Gaffney
For hospital systems, physician groups, laboratories and other healthcare providers, Lauren Gaffney analyzes and counsels clients on the regulatory requirements and operational impacts related to day-to-day operations and the purchases and sales of healthcare facilities, including those related to fraud and abuse.
Lauren also focuses on internal investigations, which involve responding to governmental inquiries regarding potential regulatory, compliance and clinical issues. She recently represented a hospital involved in a Department of Justice and U.S. Department of Health and Human Services – Office of the Inspector General (HHS-OIG) investigation, resulting in the dismissal of claims brought forth under the False Claims Act (FCA).
By helping the nation’s largest children’s research hospital obtain a Certificate of Need, Lauren’s research and guidance throughout the related proceedings helped her client move closer to its goal of developing the first dedicated pediatric proton therapy facility in the United States.
Memberships
American Health Lawyers Association (AHLA) — ACO Task Force
American Inns of Court
Health Care Compliance Association
Nashville Health Care Council — Leadership Health Care
Tennessee Bar Association
Nashville Emerging Leaders — Class of 2014
Representative Experience
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Co-counsel to Methodist Le Bonheur Healthcare (MLH) in its efforts to obtain a Certificate of Need (CON) to initiate radiation therapy at its hospital campus located in Germantown, Tennessee
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Served as lead counsel to Radiology Alliance – an affiliate of MEDNAX, Inc. – in its efforts to obtain a Certificate of Need (CON) to implement a new, state-of-the-art outpatient diagnostic imaging center in Metropolitan Nashville area
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Successfully defended a number of clients across industry sectors, including hospitals, physician practices, hospices, home health agencies and DMEPOS suppliers, in appealing audit results where statistical sampling was used to calculate to extrapolated overpayment demands.
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Currently serve as outside counsel for one of the largest national hospice providers, handling audit response issues and appealing unfavorable audit results, which has resulted in overturning millions of dollars in overpayment demands.
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Represented Pharos Capital Group in its acquisition of Horizon Oncology
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Represented Sheridan, the Physician Services division of AmSurg Corp. (NASDAQ: AMSG), in its acquisition of Northside Anesthesiology Consultants, LLC
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Successfully defended a home health agency in appealing a $9.3 million extrapolated overpayment resulting from a ZPIC audit
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Served as lead counsel to a consortium of charitable foundations in their efforts to obtain a Certificate of Need (CON) to build a $110 million proton beam therapy facility in suburban Nashville, Tennessee
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Representation of hospital in DOJ/HHS-OIG investigation of physician relationships, resulting in declination of intervention by the government and district court’s dismissal of relator’s FCA claims
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Representing a hospital in appealing an overpayment demand of more than $800,000 after a Zone Program Integrity Contractor (ZPIC) unfavorable audit
Publications
Media Mentions & Firm News
Accolades
Mid-South Super Lawyers “Rising Star” (2014-2018)
Tennessee Bar Association Pro Bono Honor Roll (2012)
Scholastic Excellence Award — Health Law & Policy; Professional Responsibility
Vanderbilt Law Review — Notes Editor
Professional Road Cyclist (2002-2005)
Collegiate National Cycling Championship (2003)
