Deborah Kantar Gardner is a Boston-based partner in Ropes & Gray’s health care practice. Ms. Gardner’s practice focuses on Medicare and Medicaid payment, compliance and enforcement matters, including administrative and judicial litigation in connection with Medicare and Medicaid payment matters.
Deborah’s clients include hospitals and health systems, health plans/managed care organizations, clinical diagnostic laboratories, dialysis and pharmaceutical companies, physician and therapy practices, and durable medical equipment suppliers.
Deborah defends health care entities in connection with federal and state civil False Claims Act investigations and qui tams. She represents clients in connection with Administrative Law Judge appeals of Recovery Audit Contractor, Zone Program Integrity Contractor and Medicaid Integrity Contractor audits as well as with respect to Provider Reimbursement Review Board appeals.
Deborah counsels clients on compliance with federal health care program authorities, including Medicare and Medicaid, and federal fraud and abuse laws. She represents clients in connection with Medicare enrollment and survey and certification matters, including terminations. She also advises clients on Medicare billing, coding and payment matters.
- AB (American History and Literature), cum laude, Harvard College, 1985
- JD, University of Pennsylvania Law School, 1989
- Massachusetts, 1989
- U.S. Court of Appeals for the Second Circuit, 2018
- U.S. Court of Appeals for the District of Columbia, 1991
- U.S. District Court for the District of Massachusetts, 1989
- Supreme Judicial Court of Massachusetts, 1989
- Conducted and assisted in the resolution of an investigation into a residential service provider jointly conducted by the New York Attorney General’s Medicaid Fraud Control Unit and the United States Attorneys’ Office for the Southern District of New York.
- Successfully defended a major New York health system in connection with a False Claims Act investigation brought by the United States Attorneys’ Office for the Southern District of New York.
- Successfully represented a New York hospital in connection with a Medicare program integrity audit of the medical necessity and inpatient admission for certain cardiac procedures.
- Successfully represented several hospitals in challenges to Medicare and Medicaid program integrity and Recovery Audit Contractor audits.
- Successfully represented health care entities in numerous Administrative Law Judge and Medicare Appeals Council appeals involving, among other things, issues of medical necessity and/or inpatient status.
- Regularly assists diagnostic laboratories in connection with Medicare payment suspensions, Medicare program integrity audits, and commercial payor disputes.
- Successfully represented many hospitals in connection with Medicare termination proceedings and System Improvement Agreement negotiations.
- Counsels health care entities on compliance with Medicare and Medicaid authorities, including billing and coding, survey and certification, charges and co-payments, reporting and returning overpayments, and self-disclosures.
- Represents Medicaid Managed Care Organizations in connection with qui tam defense, contracting and compliance.
Rate : $$$