Colin helps healthcare providers navigate the intricate maze of regulations governing the healthcare industry, with a focus on health care reimbursement, audits and investigations, HIPAA, and licensing, enrollment, and certification issues.
Colin’s practice focuses on advising healthcare providers and suppliers on the complex regulations governing reimbursement from Medicare, Medicaid, and other federal and private payers. Hospitals, health systems, surgery centers, physician practices, home health agencies, behavioral health and addiction treatment providers, pharmacies, durable medical equipment suppliers, and other healthcare providers and suppliers benefit from Colin’s significant experience and efficient, practical advice on a variety of reimbursement and compliance issues, including: billing and coding, overpayments and self-disclosures, reimbursement disputes, exclusions, government audits and investigations, changes of ownership, Medicare Conditions of Participation and Conditions for Coverage, provider-based status, HIPAA, the False Claims Act, Stark and Anti-Kickback laws, development and implementation of compliance programs, and other regulatory compliance issues.
In healthcare transactions, Colin counsels clients on thorny regulatory issues identified in due diligence, and advises on strategies to mitigate potential risks, including submissions of voluntary refunds, self-disclosures, and advisory opinion requests to the Office of Inspector General (OIG). Colin has extensive experience working with the Centers for Medicare and Medicaid Services (CMS), state Medicaid agencies, accreditation bodies, and state licensing agencies across the country on enrollment, accreditation, licensure, and certification issues. He leverages his contacts and experience to help clients structure transactions and operations to minimize business disruptions and assists clients with the associated regulatory filings with federal and state agencies.
Colin frequently writes and presents on emerging reimbursement and compliance issues and is active in the American Health Lawyers Association. Colin maintains an active pro bono practice through the Legal Information Network for Cancer, using his understanding of healthcare reimbursement to assist cancer patients with coverage and payment issues. In 2018-2020, Colin was recognized by Super Lawyers as a “Virginia Rising Star” in healthcare law.
- Represented academic medical center in ALJ hearing before the Office of Medicare Hearings and Appeals (OMHA) in a significant overpayment dispute.
- Represented an academic medical center in Medicaid appeal regarding high-dollar claim denial.
- Represented hospital in successful appeal of CMS’ termination of sole community hospital status.
- Represented hospital in successful appeal of CMS’ termination of Critical Access Hospital status.
- Represented multiple physician practices in OIG self-disclosures and settlements regarding incident-to billing.
- Represented health system in OIG self-disclosure and settlement regarding excluded individual.
- Represented physician practices in CMS Self-Referral Disclosure Protocol submissions.
- Represented of healthcare providers in requesting advisory opinions from the OIG.
- Represented national ASC management company in regulatory filings and approvals for acquisitions of multiple ASCs.
- Led the regulatory filings and approvals process for a health system in acquisition of two hospitals.
- Led the regulatory filings and approvals process for multiple acquisitions of physician practices, pharmacies, DME suppliers, and physical therapy practices.
- Represented dozens of healthcare providers in administrative appeals of Medicare, Medicaid, and commercial payer audits.
William & Mary Law SchoolJD
Member, William & Mary Law Review2010
- Christopher Newport UniversityBA2007
Vice Chair, American Health Lawyers Association Accreditation, Certification, and Enrollment Affinity Group, 2016 – present
Pro Bono Attorney, Legal Information Network for Cancer, 2015 – present
Member, American Health Lawyers Association
Member, Health Law Section, Virginia Bar Association
Member, Health Care Section, Virginia State Bar
Member, Health Care Compliance Association
Member, Healthcare Financial Management Association
- Speaker, HIPAA and Healthcare Transactions, November 2, 2022
- Moderator, "Behavioral Health & Substance Abuse Treatment", 15th Annual Healthcare Finance and Growth Conference, September 15, 2022
- Speaker, "2019 Medicare and Medicaid Year In Review", AHLA Institute on Medicare and Medicaid Payment Issues, March 25, 2020
- Speaker, "Government Enforcement Actions Against Providers", Healthcare Litigation and Compliance Webinar Series, July 19, 2018
- Speaker, "Best Practices for Responding to Medicare Claims Audits and OIG Compliance Audits", Healthcare Litigation and Compliance Webinar Series, March 22, 2018
- Speaker, "Year in Review", Institute on Medicare and Medicaid Payment Issues, March 2017
- Co-presenter, "Provider-Based Status: Recognizing Evolving Compliance Risks and Remembering the Fundamentals", American Health Lawyers Association Fraud & Compliance Forum, October 2016
- Co-presenter, "Developing and Implementing Hospital Capital Projects", Virginia Hospital & Healthcare Association, March 2016
- Co-presenter, "Structuring Healthcare Co-Location Arrangements", Strafford Webinar, June 2015
- Presenter, "Healthcare Regulation", Virginia Commonwealth University eMBA Program, June 2015
- Moderator, "Hospital Co-Location", American Health Lawyers Association Webinar, May 2015
- Co-presenter, "Inpatient or Observation? Practical Advice for Hospitals on Compliance with CMS' 'Two Midnight' Benchmark", Healthcare Financial Management Association VA/DC Spring Education Conference, March 2014
- Co-presenter, "Payer Audit, Enforcement & Compliance: Are You a Target", Medical Group Management Association Virginia Chapter, December 2013
- Co-presenter, "A New Era of Government Enforcement: Strategies for Preparing for and Responding to Government Audits", Health Care Compliance Association Clinical Practice Compliance Conference, October 2013
- Co-presenter, "Avoiding Costly Medicare Enrollment Errors", Healthcare Financial Management Association VA/DC Summer Conference, August 2011
Named to “Virginia Rising Stars,” Health Care, Super Lawyers, Thomson Reuters, 2018, 2019, 2020
- Author, Office for Civil Rights Settlement May Signal Increasing Scrutiny for Ransomware Attacks, McGuireWoods Legal Alert, November 21, 2023
- Author, HHS Proposes Information Blocking Disincentives to Complement Existing Penalties, McGuireWoods Legal Alert, November 14, 2023
- Author, CMS Increases Oversight and Scrutiny of Hospices, McGuireWoods Legal Alert, September 1, 2023
- Author, Private Equity in Healthcare – An Updated Review of Selected Niche Investment Areas, McGuireWoods Legal Alert, August 7, 2023
- Author, CMS Proposes 36-Month Rule for Medicare-Enrolled Hospices, McGuireWoods Legal Alert, July 19, 2023
- Author, Five Things Healthcare Providers Peer Review Privilege, McGuireWoods Legal Alert, July 10, 2023
- Author, Reproductive Health Confidentiality: HHS Proposes Stronger Privacy Measures, McGuireWoods Legal Alert, July 5, 2023
- Author, HIPAA Privacy Rule Changes Coming in 2023: Five Steps to Prepare, McGuireWoods Legal Alert, May 3, 2023
- Author, CMS Publicly Releases Ownership Data for Medicare-Certified Hospice and Home Health Agencies, McGuireWoods Legal Alert, May 2, 2023
- Author, End of COVID-19 Emergency: Legal Implications for Healthcare Providers, McGuireWoods Legal Alert, May 1, 2023
- Author, Outdated Medicare Enrollment Data? Caution: CMS Verifying Ownership, McGuireWoods Legal Alert, April 26, 2023
- Author, HIPAA Enforcement Discretion Ends When Public Health Emergency Expires on May 11, McGuireWoods Legal Alert, April 19, 2023
- Author, Court Strikes No Surprises Act’s Dispute Resolution Process for Air Ambulance Providers, McGuireWoods Legal Alert, August 19, 2022
- Author, Eye Care Practice Settles with Government for Employing Excluded Individual, The FCA Insider, March 25, 2022
- Author, CMS Vaccine Mandate Enforcement Begins — Understanding the Three Deadlines, McGuireWoods Legal Alert, January 27, 2022
- Author, Supreme Court Upholds CMS Vaccine Mandate: Next Steps for Healthcare Providers, McGuireWoods Legal Alert, January 14, 2022
- Quoted, "Opponents of Health Worker Vaccine Mandate Aim for Right Court", Bloomberg Law, November 22, 2021
- Author, Takeaways From New CMS Interim Rule Requiring COVID-19 Vaccination for Healthcare Providers and Suppliers, McGuireWoods Legal Alert, November 5, 2021
- Author, CMS Accelerated and Advance Payment Recoupment Begins, McGuireWoods Legal Alert, April 6, 2021
- Author, 5th Circuit Weakens HHS Ability to Enforce HIPAA Safeguards, Password Protected, January 27, 2021
- Author, "Legal Issues: Guidance for Recipients of Provider Relief Fund Payments", RPA News, January 2021
- Author, CMS Updates Medicare Accelerated and Advance Program Repayment Guidance and Start Date, McGuireWoods Legal Alert, October 28, 2020
- Author, Hacked Patient Records Land Athens Orthopedic Clinic in Hot Water With OCR, Password Protected, September 25, 2020
- Author, Recent Physical Therapy Enforcement Actions Highlight Compliance Concerns, McGuireWoods Legal Alert, June 19, 2020
- Author, CMS Suspends Advance Payments and Re-evaluates Accelerated Payments, McGuireWoods Legal Alert, April 28, 2020
- Author, “Hospitals Without Walls” and Other Flexibilities for Hospitals During COVID-19, McGuireWoods Legal Alert, April 24, 2020
- Author, CMS Waives Certain Requirements to Expand Healthcare Workforce, Put Patients Over Paperwork, McGuireWoods Legal Alert, April 15, 2020
- Author, Five Points ASCs Should Consider Before Enrolling as a “Hospital” During the COVID-19 Crisis, McGuireWoods Legal Alert, April 6, 2020
- Author, Payment Advances for Medicare Providers, Suppliers May Ease Liquidity Issues – Six Key Points, McGuireWoods Legal Alert, March 30, 2020
- Author, CMS Eases Healthcare Provider Enrollment Process in Response to COVID 19 Crisis, McGuireWoods Legal Alert, March 27, 2020
- Author, Federal Authorities Crack Down on Fraudulent COVID-19 Schemes, The FCA Insider, March 26, 2020
- Author, Healthcare Private Equity Responses to COVID-19: Nine Things to Consider as the Pandemic Worsens, McGuireWoods Legal Alert, March 19, 2020
- Author, HHS Acts to Support Telehealth Services in Response to COVID-19: Six Key Takeaways, McGuireWoods Legal Alert, March 18, 2020
- Author, 10th Circuit Finds Falsified Quality Data Immaterial for FCA Cases Under Escobar, The FCA Insider, March 10, 2020
- Author, CMS Issues Long-Awaited Guidance on Hospital Co-Location Policy, McGuireWoods Legal Alert, May 9, 2019
- Co-author, "CMS’ Role in Hurricane Disaster Relief Efforts", The RAP Sheet, December 2017
- Author, CMS Provides Waivers in States Affected by Hurricanes Harvey and Irma, McGuireWoods Legal Alert, September 20, 2017
- Author, CMS Open Payments: A Look Behind the Curtain, McGuireWoods Legal Alert, July 5, 2017
- Author, Increased Focus on Health Care Cybersecurity: HHS Releases Long-Awaited Report and Cyber Attack Quick-Response Checklist, Password Protected, June 29, 2017
- Author, "Do We Have an Overpayment? How the 60-Day Rule and Escobar Impact a Compliance Investigation", Bender's Health Care Law Monthly, February 2017
- Co-author, "Distinct Part Units", AHLA Representing Hospitals and Health Systems Handbook, September 2016
- Co-author, "CMS Aims To Curb Hospital Access To Provider-Based Billing", Law360, July 2016
- Author, "The Final 60-Day Rule is Here: What Healthcare Providers Need to Know", HCCA Compliance Today, May 2016
- Author, "First 60-Day Rule Enforcement Cases Unfavorable To Healthcare Providers", HCCA Compliance Today, November 2015
- Co-author, "The Risky Business of Co-Location Arrangements", AHLA Connections, March 2015
- Author, "Managing the Medicare Prepayment Review Process", Virginia Health Care Association Legal Quarterly, December 2014
- Co-author, "Responding to CMS Overpayment Demands: Practical Steps for Appeal", ABA Health Lawyer, August 2014
- Co-author, "Understanding the 60-Day Repayment Rule", Advisory Board Law Review, January 2014
- Co-author, "The Potential Impact of the Fiscal Cliff Deal on Provider Audits", Advisory Board Daily Briefing, February 2013
- Author, "Medicare’s Secret Weapon in the Fight Against Fraud", Virginia Medical Law Report, September 2012
- Author, "Paging Dr. Google: Personal Health Records and Patient Privacy", 51 William & Mary Law Review 2243, May 2010