Biography
Mathew J. Levy is a Partner of the Firm and the Co-Chair of the Firm’s corporate, transactional and healthcare practice groups. Mr. Levy has particular experience in, structuring and negotiating joint venture agreements, stock purchase, asset sale agreements, shareholders agreements, partnership agreements, settlement agreements, employment contracts, managed care agreements and commercial leases. Among the areas in which he focuses are coordinating mergers and acquisitions, compliance programs, ambulatory surgery centers, establishment of diagnostic and treatment centers, HIPAA privacy regulations, fee-splitting issues, Stark law issues, fraud and abuse rules and regulations and Medicare/ Medicaid, Oxford, Americhoice and other third party payor audits. A dynamic speaker and prolific author, he has lectured at Yale University, Beth Israel Medical Center, NYU Downstate Hospital, Columbia Presbyterian Hospital, St. Vincent’s Hospital & Med Center, Long Island Jewish Medical Center among others on a wide range of health law issues including multi-specialty groups, fraud and abuse, medical records, confidentiality of protected health information, employment contract negotiations, and licensure issues related to interviews and hearings with the Office of Professional Medical Conduct as well as the Office of Professional Discipline. He has authored numerous articles on various health law topics including Physician Employment Agreements, Managed Care Audits, Physician Leases, The Anti-Kickback Statute, Asset Protection, and Concierge Medical Practices among others and has been featured on a cable TV show “The Hot Seat”. Mr. Levy advises healthcare clients on the day-to-day business operations that have the attention of the FBI, Office of Inspector General, District Attorneys and the U.S. Attorneys Office.
Prominent Matters
- Employment Law/ Labor Law Win! – we successfully opposed a claim of pregnancy discrimination and wrongful termination brought against our client the (Employer) before the New York City Commission on Human Rights (“NYCCHR”). After receiving our response to the allegations, including an accurate description of the facts and the legal argument demonstrating that the Petitioner (Employee) did not have a viable case, the NYCCHR concluded that further prosecution of the case was not in the public interest. The NYCCHR informed the parties that it has closed the matter.
- Successfully defended (OPD) Office of Professional Discipline investigation with a complete closure of the matter and no disciplinary action taken against the client.
- Successfully defended a Medicare overpayment demand at hearing and reduced the overpayment demand by $1.3 million.
- Successfully represented several clients that sold their medical practices to private equity companies.
- Successfully represented many large physician groups that were on prepayment review and successfully removed the prepayment flag.
- Successfully defended a New York based Medical practice from a Centers for Medicare and Medicaid Services (CMS) Uniform Program Integrity Coordinator (UPIC) audit. The UPIC initially found an overpayment of over $1,500,000. After a favorable appeal, the overpayment has been reduced to under $12,000.
- Successfully defended an ABA provider and this ABA Provider is now reinstated with full billing authorization related to Optum investigation and suspension.
- Successfully appealed Workers Compensation Board termination of Physician resulting in a full reinstatement.
- Successfully appealed provider participation to Emblem Health resulting in a full reinstatement.
- Successfully defended several physicians related to Office of Professional Medical Conduct investigations resulting in a full closure of investigation with no disciplinary action.
- Successfully appealed suspension of provider billing privileges resulting in a full reinstatement.
- Successfully represented a large physician practice in False Claims Act investigation involving allegations of healthcare fraud and kickbacks; obtained resolution.
- Successfully represent healthcare practices related to HIPAA breach; obtained resolution.
- Successfully represented several healthcare practices in DOJ investigations.
- Successfully represented Durable Medical Equipment State and Federal investigations.
- Reinstated removal from prepayment review.
- Overturned overpayment demand.
- Successfully overturned multi-million-dollar Medicare and Medicaid overpayment demands.
- Successfully negotiated settlement agreements with the US Attorney’s alleged healthcare fraud.
- Successfully formed several Ambulatory Surgery Centers and Diagnostic Treatment Centers and advised clients on the Certificate of Need process.
- Successfully structured acquisition of nine healthcare facilities in addition to the purchase of the medical business and related real estate.
- Drafted and negotiated commercial lease agreements on behalf of healthcare clients.
- Created and structured asset protection and estate planning models for clients protecting millions of dollars of clients’ assets.
- Structured and negotiated sale of multi-million dollar publicly traded healthcare company.
- Formed Independent Practice Association (IPA) in New York.
- Negotiated settlements with the US Attorney’s Office on behalf of a client, related to corporate integrity agreements.
- Structured concierge medical practices.
- Represented clients related to OIG, OMIG, DOH, DEA, OCR, OSHA, and MAC investigations.
Published Works
- Financial Arrangements Between Anesthesiologists, Ambulatory Surgical Centers and Gastroenterologists
- Medicare & Medicaid Overpayment Demands/Audits: How To Avoid Them
- Understanding Telemedicine And The Effect Of The Government Shutdown on Telemedicine
- Understanding Physician Websites and Compliance
- Understanding Healthcare Billing Disputes: Navigating Legal Risks For Physicians
- How The Title of “Disruptive Physician” Can Ruin Your Career And How To Avoid It
- Medical Spas and The Danger of Delegating Laser Hair Removal to a Non-Medical Professional
- Understanding The Healthcare Fraud Investigation
- Merger and Acquisition Self-Disclosure Safe Harbor Announced
- Is Your Practice Under Investigation By The FBI, OIG, OMIG IRS OPMC or OPD?
- Merger and Acquisition Self-Disclosure Safe Harbor Announced
- Is Your Practice Waiving or Not Collecting Co-Payments?
- Is Your Practice Being Audited?
- New Requirements for Upcoming Healthcare Transactions
- Mandatory Healthcare Worker Bonus Program
- Business Entity Formation: Choosing The Right Business Structure For Your Needs
- Heavy HIPAA Enforcement Efforts!
- Understanding Dental Employment Contracts
- The 21st Century Cures Act Final Rule Has Taken Effect
- Ambulatory Surgery Centers As Investments
- Compliance Concerns Rise As Information Blocking Rules Become Fully Mandatory
- Medicare Payments On Hold Pending Congressional Sequester Fix
- NYS OMIG Streamlines Compliance Certification Requirements
- 2020 OIG Compliance Work Plan
- Understanding Physician Employee Manuals
- New Investigations Related To COVID-19
- Understanding Private Equity Transactions In Healthcare
- CMS Announced Expansion Of Accelerated And Advance Payments Program For Providers And Suppliers During COVID-19 Public Health Emergency
- Stark Law Waivers Amidst COVID-19 Crisis
- COVID-19 And The Increased Demand For Lawyers’ Expertise
- New Medicare Rule
- Understanding the Issues Related to Concierge Medicine, Westchester Physician, Westchester County Medical Society
- Understanding The Medicare Fraud Investigation
- Understanding the Legal Ramifications Involving Medispas
- Understanding the Negotiation of Managed Healthcare Contracts
- New Guidance Issued By Medicare Involving Extrapolation
- Greenway Health, LLC Improper EHR Calculation
- Deadline Approaching For Reporting 2018 HIPAA Breaches
- Understanding Compliance
- New York’s Mandatory Compliance Program Obligation Deadline Approaching
- Featured in the Journal of the Nassau County Bar Association June 2018: Understanding The Legal Implications Involving Management Services Organizations
- CMS Offers Possible Settlement Option For Providers With Pending Medicare Appeals
- Understanding Family Leave Benefits in New York
- Telehealth Audits To Be Added To OIG Work Plan
- Understanding Third Party Payor Audits Affecting Physicians
- Understanding EUOS and New Guidance Involving Corporate Structure
- Understanding The Process of Leaving A Large Mega Group or Hospital After a Merger
- Understanding Retrospective Audits and How to Avoid Them
- Understanding Matters Before the Office of Professional Medical Conduct (OPMC)
- Understanding the Process of Selling a Medical Practice
- Understanding Telemedicine
- Understanding Physician Employment Contracts When Joining a Hospital
- Understanding General Business Lease Agreements
- Understanding Physician Lease Agreements
- Emergency Services and Surprise Bills
- Understanding Financial Arrangements Between Chiropractors And Other Licensed Healthcare Professionals
- Understanding Physician Partnership/Shareholders’/Operating Agreements
- Office Based Surgical Procedure Audits – How to Handle Them
- Understanding Financial Arrangements Between Anesthesiologist and Ambulatory Surgical Centers as per the Recent OIG Opinion
- Understanding Ambulatory Surgery Centers
- Understanding Business Associates
- Understanding General Business Employee Manuals
- Understanding Physician Advertising
- Understanding Succession Planning
- Understanding Prepayment Audit Reviews
- Understanding IPAs
- Understanding Third Party Vendor Relationships, MSSNY’s News of New York
- Understanding The Process Of Starting A Chiropractic Practice
- Understanding How to Respond to a Visit from an Investigator
- Understanding The Process of Merging Your Medical Practice with A Large Mega Group or Hospital
- Understanding Physician Lease Agreements & The Anti-Kickback Statute
- Understanding Chiropractor Lease Agreements & The Anti- Kickback Statute
- Understanding The Retail Based Clinic Debate, Westchester Physician
- Understanding Asset Protection and Family Limited Partnerships, The Caduceus, Dutchess County Medical Society
- Understanding Estate Planning and Wills. The Bulletin, Medical Society Counties of Erie and Chautauqua
- Understanding the Process of Starting a Medical Practice
- Understanding Chiropractor Lease Agreements and The Anti-Kickback Statute
- Understanding the Process of Starting a Medical Practice, The Bulletin, Onondaga County
- Understanding The Process of Merging Your Practice With A Large Mega Group or Hospital, MSSNY’s News of New York
- Financial Arrangements Between Anesthesiologists, Ambulatory Surgical Centers and Gastroenterologists
- Retrospective Audits: How to Avoid Them, New York State Pediatrician, American Academy of Pediatrics
- Understanding Physician Employment Contracts, Westchester Physician, Westchester County Medical Society
- Understanding Partnerships, Limited Liability Companies & Corporations, Westchester Physician, Westchester County Medical Society
- Understanding Physician Lease Agreements and The Anti-Kickback Statute, The Caduceus, Dutchess County Medical Society
- Healthcare Fraud: Self-Disclosure Protocol Update, Nassau County Bar Association Journal
- OCR’ Audit Report Reveals Concerns That Continue To Guide HIPAA Enforcement
- Client Alert: CMS And OIG Move To Expand Exceptions And Safe Harbors To Stark Law And Anti-Kickback Statute
- Medicare & Medicaid Overpayment Demands/Audits: How To Avoid Them
