Gregory M. Fliszar Ph.D.*

Serves as outside general counsel to a behavioral health provider.

Served as outside HIPAA/privacy counsel for a multi-state senior living company.

Represented a multi-hospital health system in a dispute against a national health insurer related to improper inpatient denials, Diagnosis-Related Group (DRG) downgrades, and other underpayments resulting in an eight-digit settlement and favorable contract changes going forward.

Represented multi-hospital health system in a dispute against a national health insurer related to untimely claims appeals determinations resulting in a favorable settlement and operational changes by insurer to address the untimely appeals going forward.

Represented a multi-hospital health system in a dispute against a national Medicare Advantage MCO related to improper denials and downgrades of inpatient claims.

Represented an academic children's medical center in a dispute against a Medicaid MCO involving denials and downgrades of inpatient admissions resulting in an eight-digit settlement.

Represented a large, multi-state health system in a federal sequestration-related reimbursement matter, obtaining favorable settlement and contract changes going forward.

Represented a large academic health system before the Provider Reimbursement Review Board (PRRB) relating to the disallowance of the costs incurred for its allied health program.

Represented multiple health systems before the PRRB and in federal district and appellate courts to challenge Medicare disproportionate share hospital (DSH) payments.

Represented an academic children's hospital against a national health insurer for improperly denying and downgrading payments for behavioral health services resulting in a favorable settlement.

Represented a multi-state hospital system in 340B underpayments.

Represented a national hospice provider before a state Medicaid appeals board in multiple appeals relating to Medicaid underpayments for services provided, resulting in a significant number of denials being reversed and paid with interest.