Lauren M. Gaffney
For hospital systems, home health and hospice, physician groups, dental organizations and other healthcare providers, Lauren Gaffney analyzes and counsels clients on the regulatory requirements and operational impacts related to day-to-day operations, 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.
Recognizing that the landscape of healthcare law is constantly changing, Lauren advises clients on business decisions related to delivering superior patient care, within a heavily regulated industry. Her experience includes former positions as operations counsel intern for Hospital Corporation of America (HCA Inc.) and as an intern for Vanderbilt University Risk and Insurance Management.
Memberships
American Health Law Association (AHLA)
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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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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We successfully defended a regional home health agency in a responding to an audit conducted by the Office of Audit Services of the Health and Human Services’ Office of Inspector General (OIG-OAS) and appealing the results recommended in the OIG-OAS final report. Our representation resulted in a reduction of the multi-million dollar overpayment in the OIG-OAS final report by 30 percent and recoupment to less than $10,000.
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We successfully defended a regional hospice in a responding to an audit conducted by the Office of Audit Services of the Health and Human Services’ Office of Inspector General (OIG-OAS) and appealing the results recommended in the OIG-OAS final report. Our representation resulted in a reduction of the original overpayment in the OIG-OAS final report from $7.3 million to $79,000 on appeal.
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We have successfully represented several hospitals in making self-reports of potential violations of the Emergency Medical Treatment and Labor Act (EMTALA). After consideration of the self-reports, the Centers for Medicare & Medicaid (CMS) , Successful Defense of Home Health Agency in OIG-OAS Audit
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We successfully defended a home health agency in a responding to an audit conducted by the Office of Audit Services of the Health and Human Services’ Office of Inspector General (OIG-OAS) and appealing the results recommended in the OIG-OAS final report. Our representation resulted in a reduction of the original overpayment in the OIG-OAS final report from over $7 million to $79,000 on appeal.
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Lead counsel to West Tennessee Healthcare in obtaining a Certificate of Need (CON) to convert its existing hospital-based outpatient surgery center to a freestanding multi-specialty surgery center that will provide state-of-the art services
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Lead counsel to a Memphis-based children’s research hospital in obtaining a Certificate of Need (CON) to initiate home health services
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Lead counsel to Acadia Healthcare Company, Inc. in its efforts to obtain a Certificate of Need (CON) to open a state-of-the-art opioid treatment program (OTP) facility in suburban Nashville, Tennessee
Publications
Past Events
Media Mentions & Firm News
Accolades
Leadership Council on Legal Diversity (LCLD) — Fellow (2021)
Mid-South Super Lawyers “Rising Star” (2014-2021)
Scholastic Excellence Award — Health Law & Policy; Professional Responsibility
Vanderbilt Law Review — Notes Editor
Professional Road Cyclist (2002-2005)
Collegiate National Cycling Championship (2003)
