Bob has more than 20 years of experience providing public and private clients with strategic advice and guidance on Medicare, Medicaid, and other payer regulatory, compliance, licensure, and reimbursement issues. He is widely recognized for his broad and diverse experience on behalf of providers, payers, boards of directors, and other health care industry stakeholders with regards to the development and implementation of compliance programs; the performance of compliance due diligence and effectiveness reviews; the provision of interim compliance services; internal investigations; and the full range of regulatory matters, including self-disclosures, audit defense, settlement negotiations, and Justice Center matters.
Bob previously served as the first deputy for the New York State Office of the Medicaid Inspector General (OMIG), where he provided strategic planning and leadership related to program integrity for New York's $50 billion Medicaid program. He was directly responsible for the implementation of mandatory provider compliance plans and corporate integrity agreements and chaired provider advisory committees focused on compliance guidance, self-disclosures, and OMIG's audit processes.
Prior to joining the OMIG, Bob served as chief compliance officer for a comprehensive health care system comprised of over 15 affiliates and 4,000 employees.
- Served as interim chief compliance and privacy officer for a variety of health care organizations ranging from a large academic medical center to a small health and human services organization.
- Represented multiple providers related to OMIG compliance effectiveness reviews.
- Counsel DSRIP Performing Provider Systems (PPS), ACOs, and FIDA plans on program integrity obligations and strategies.
- Represented providers at administrative hearings related to OMIG audits and patient discharge issues.
- Advised a specialty lab related to CIA readiness.
- Provided training to association members on conducting effective abuse and neglect investigations.
- Provided representation and education to employees and multiple provider agencies on their rights and responsibilities related to OPWDD and NYS Justice Center investigations.
- Drafted legislation to limit/clarify the authority of the NYS Justice Center.
- Represented numerous payers/providers at OMIG meetings related to the formation of audit and investigation protocols.
- Negotiated terms of self-disclosures, repayment agreements, and audit stipulations with OMIG.
- Conduct compliance effectiveness reviews for hospitals, managed care plans, homecare providers, transportation companies, and health and human services organizations.
- Guided a homecare agency through a HIPAA privacy breach disclosure related to an incident involving more than 500 individuals.
- Currently serve as a facilitator for a hospital association’s compliance work group.
- Co-chair of the NYS DOH Value Based Payment (VBP) Program Integrity work group.
- Union College, B.A., 1993
- Western New England College School of Law, J.D., 1996
- Union College, M.S., Health Systems Management, 2000
- New York
- New York State Bar Association, Health Law Section, Chair
- Health Lawyers Association, Member
- New York State Bar Association, Health Law Section, Former Vice-Chair
- New York State Bar Association, Reimbursement, Enforcement and Compliance Committee, Former Co-Chair
- Health Care Compliance Association, Former Board Member
- Co-authored two chapters of CCH's Health Care Compliance Professional's Manual
- Manatt, Phelps & Phelps, LLP, Counsel
- Deloitte, Senior Manager
- New York State Office of the Medicaid Inspector General, First Deputy
- Northeast Health, Compliance Officer
- New York State Governor’s Office of Regulatory Reform, Assistant Counsel