Christopher L. Keough regularly represents hospitals in reimbursement litigation involving payments for disproportionate share hospitals (DSH), the calculation of prospective payment system rates, payments for graduate medical education (GME) costs and other reimbursement issues.
Christopher also represents clients in administrative, civil and criminal actions involving alleged false claims or fraud and abuse in federal health programs. The remainder of his practice consists of counseling with regard to federal health regulatory matters.
- Has served as lead counsel in several of the largest reimbursement disputes in the history of the Medicare program, often prevailing on issues of first impression.
- Practice focuses on Medicare and Medicaid reimbursement and compliance.
- Medicare Reimbursement Litigation
- Represented nearly 700 hospitals, including the hospitals involved in the national lead case that successfully overturned rural floor budget neutrality adjustment to the base payment rate under the Medicare prospective payment system for inpatient hospital services.
- Represented more than 400 in a successful court action leading to repeal of a payment rate reduction in connection with the “two-midnights” rule.
- Obtained the first-ever decision from a federal court requiring the Department of Health and Human Services (HHS) to correct several systemic errors and omissions in the data and processes used to calculate the Medicare/SSI fraction that determines the Medicare DSH payments to hospitals that serve a disproportionate share of low-income patients.
- Secured district court ruling invalidating a final rule that delayed by one year the effective date of a required hospital outpatient payment adjustment for the nation’s leading cancer treatment and research institutions.
- Secured a key win in the lead case among 270 consolidated federal court suits involving more than 600 hospitals seeking additional DSH payment for eligible-but-unpaid Medicaid patient days; obtaining district court order granting summary judgment for the hospitals in the lead case; successfully defending the district court’s judgment appeal before the U.S. Court of Appeals for the District of Columbia Circuit; and successfully opposing the solicitor general’s petition for review by the Supreme Court, notwithstanding the government’s assertion of a circuit split on a nationally important issue and $2.8 billion of potential liability for the government. Played a central role in negotiating a global settlement, following the successful litigation of the lead case, involving payment of more than $660 million to the hospitals in the consolidated litigation.
- Medicaid Reimbursement:
- Successfully defended an appeal to the U.S. Court of Appeals for the District of Columbia Circuit from a district court order requiring the District of Columbia to make additional Medicaid DSH payments to a group of D.C. hospitals.
- Represented a state university-affiliated teaching hospital in connection with the determination of uncompensated care cost limit on its federal matching payment for Medicaid DSH payments.
- Compliance/Fraud and Abuse:
- Assisted in the defense of a major accounting firm in a civil action brought under the False Claims Act for hospital laboratory claims.
- Acted as regulatory counsel in the successful defense of a criminal action alleging health care fraud with respect to Medicare cost report claims submitted by a home health agency.
- Member, American Health Lawyers Association.
- Member, Healthcare Financial Management Association (VA/DC Chapter).
- Member, American Bar Association.
- J.D., The George Washington University Law School, 1991
- B.A., Franklin & Marshall College, 1987
- U.S.D.C., District of Columbia
- District of Columbia
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