Brett Witham is a Partner at Verrill Dana and a member of the Health Care Group and the Health Technology Group. Brett concentrates his practice in the health care industry and represents health care providers in Maine and Massachusetts in a broad array of regulatory and transactional matters, including patient confidentiality (HIPAA), informed consent, and other patient rights; physician credentialing and peer review; billing issues and compliance with fraud and abuse laws; and tax exempt and non-profit governance issues. He also advises hospitals, long term care facilities, and other providers on Certificate of Need and strategic planning issues.
Brett enjoys a special concentration in the area of provider reimbursement, including Medicare, Medicaid, and other third party reimbursement. Brett has extensive experience in long term care reimbursement from the resident assessment process through account receivable management. He has advised hospitals, long term care facilities, and physician practices on complicated and sensitive legal matters, from managing government investigations with potential civil, administrative, and criminal liability, to assisting individual practitioners with issues before licensing boards or credentialing bodies.
Brett is a frequent speaker on HIPAA and the confidentiality issues surrounding medical records, state mandatory reporting laws, and most recently, the FTC “Red Flag” rules. He was recently distinguished by peers as a "New England Rising Star" in Health Care by New England Super Lawyers.®
Representative matters:
- Representation of physician subject to Medicaid audit with substantial recoupment and termination of participation pending and convinced Medicaid to substantially reduce recoupment and withdraw termination of participation.
- Representation of long term care facility with compliance issues relating to the Resident Assessment procedures.
- Representation and support of health plan entering the Medicare Advantage market in Maine.
- Representation of licensees before state licensing boards including the pharmacy board, the nursing board, the dental board, the licensed professional counselor board, the chiropractor board, and the board of registration in medicine.
- Co-counsel for nine hospitals in coordinated Medicaid appeals and litigation that resulted in a $85 million settlement with the Maine Medicaid program.
- Successfully negotiated settlement with the Medicare intermediary on behalf of a hospital client resulting in a $160,000 payment increase with impact continuing into future fiscal years.
- Co-counsel for the Maine State Chamber of Commerce in the Dirigo Health Aggregate Measurable Cost Savings and Savings Offset Payment hearings. Worked with national health care expert at the Lewin Group to develop testimony and expert opinions relating to case that was instrumental in affecting health care finance in Maine.
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