Recent News:
Super Lawyers has selected 58 Cozen O'Connor attorneys to the 2020 Pennsylvania Super Lawyers and Rising Stars lists.
Mark concentrates his practice in client counseling and litigation involving federal and state regulation of health care providers and third-party payers. Prior to entering private practice in Philadelphia in 1988, Mark served as the deputy chief counsel to the Centers for Medicare & Medicaid Services in Washington, D.C., where he managed all litigation under the Medicare and Medicaid programs for the federal government nationally. Prior to that, Mark served for more than 10 years with the Civil Division of the U.S. Justice Department and U.S. Attorney's Office in D.C.
Perennially listed in The Best Lawyers in America and selected as a Pennsylvania “Super Lawyer" by his peers, Mark is a recipient of Martindale-Hubbell’s highest rating. He has written and lectured widely for the American Health Lawyers Association, Pennsylvania Bar Association, and other organizations on Medicare and Medicaid reimbursement, state/federal regulations under the Medicaid program, Medicaid managed care and compliance with health care fraud and abuse laws, and serves as a co-chair of AHLA’s annual Medicare and Medicaid Reimbursement Institute. He also is the author of the Medicaid Reimbursement section of the American Health Lawyers Association (Clark, Boardman, Callaghan) Health Law Practice Guide and speaks regularly at AHLA and Pennsylvania Bar Institute programs on governmental and third-party payer health care reimbursement and fraud issues. He also serves as a planning committee member and co-chair for AHLA’s Annual Medicare and Medicaid Reimbursement Institute in Baltimore.
Mark has served as counsel of record in litigation and other matters for health care systems, hospitals, pharmacy chains, durable medical equipment manufacturers and suppliers, long-term care providers, and for national and state trade associations. Mark’s representative matters for health care industry clients have included:
• Litigation resulting in the invalidation of CMS reaudit rule that prevented teaching hospitals from adding misclassified teaching costs to their base-year Average Per Resident Amounts.
• Defense of False Claim Act investigations and qui tam suits, including settlement of a Medicare “outlier” fraud case with no corporate integrity agreement.
• Rulemaking comments on behalf of national trade association contesting CMS’ proposal to eliminate Medicaid funding for graduate medical education costs.
• Formulation and legal audits of provider taxes and intergovernmental transfers (IGTs) on behalf of hospital, trade association, and governmental clients.
• Suits and high stakes arbitrations against private third-party payers and Medicaid managed care plans (involving down-codes, disallowances, breach of contract claims, and out-of-network reimbursements).
• Negotiations and restructuring of third-party payer contracts.
• Successful suits against various states challenging reductions to Medicaid reimbursement, including budget-driven Medicaid cuts and rate discrimination against out-of-state providers.
• Litigation resulting in the Third Circuit University Medical Center rule (prohibiting Medicare recoupments against health care providers operating in bankruptcy reorganization).
• Part A reimbursement hearings before the Provider Reimbursement Review Board, including a PRRB decision striking CMS’ requirement for filing duplicate claims forms with Part A intermediaries as a condition of receiving medical education supplements for Medicare managed care enrollees.
Mark earned his undergraduate degree from Rutgers University-New Brunswick in 1972 and his law degree from Georgetown University Law Center in 1975.
News
June 05, 2020
Super Lawyers has selected 58 Cozen O'Connor attorneys to the 2020 Pennsylvania Super Lawyers and Rising Stars lists.
May 14, 2020
Chambers USA, the leading annual guide to the top lawyers and law firms in the United States, has ranked 63 Cozen O’Connor lawyers as leaders in their respective fields in the guide’s 2020 edition.
August 28, 2019
Best Lawyers selected 138 Cozen O’Connor lawyers from 21 of the firm’s national offices for inclusion in the 2020 edition of The Best Lawyers in America.
May 21, 2019
Super Lawyers has selected 64 Cozen O'Connor attorneys to the 2019 Pennsylvania Super Lawyers and Rising Stars lists.
April 25, 2019
Chambers USA, the leading annual guide to the top lawyers and law firms in the USA, has ranked 57 Cozen O’Connor lawyers as leaders in their respective fields in the Guide’s 2019 edition.
August 31, 2018
Cozen O’Connor is proud to announce that seven of the firm’s lawyers have been recognized as “Lawyers of the Year” in their respective practices by Best Lawyers in America, one of the oldest and most highly regarded peer review publications in the legal profession.
August 22, 2018
One hundred twenty-six Cozen O’Connor lawyers from 20 of the firm’s national offices have been selected for inclusion in the 2018 edition of The Best Lawyers in America.
June 13, 2018
Mark Gallant, co-chair of Cozen O'Connor's Health Care practice group, spoke with CQ Roll Call about a recent Medicaid lawsuit in Kentucky.
August 23, 2017
Lawyers were selected for inclusion in the 2018 edition based on a rigorous peer-review that has been developed and defined for more than 30 years.
May 26, 2017
Chambers USA recognized 47 Cozen O’Connor lawyers as leaders in their respective fields; 14 attorneys were recognized nationally and 11 were ranked in the top band.
December 28, 2016
Mark Gallant is representing Wills Eye Hospital in its federal lawsuit seeking to overturn a U.S. Department of Health and Human Services decision that says Wills does not qualify as a hospital under Medicare.
August 16, 2016
Cozen O’Connor is proud to announce that five of the firm’s lawyers have been recognized as “Lawyers of the Year” in their respective practices by The Best Lawyers in America, one of the oldest and most highly regarded peer-review publications in the legal profession.
August 15, 2016
Sixty-two Cozen O’Connor lawyers from 13 of the firm’s national offices have been selected for inclusion in the 2017 edition of The Best Lawyers in America.
May 27, 2016
Chambers USA recognized 41 Cozen O’Connor lawyers as leaders in their respective fields; 12 attorneys were recognized nationally and 11 were ranked in the top band.
October 29, 2015
Mark H. Gallant discusses CMS rule aimed to ensure states pay providers adequate Medicaid rates so that beneficiaries have access to the same providers as the rest of the population.
August 17, 2015
The current edition is based on more than five million detailed evaluations by the top lawyers of the country. This list will be included in dozens of city and regional publications in the United States including The Wall Street Journal, The New York Times, and The Washington Post.
July 06, 2015
Chambers USA recognized 37 Cozen O’Connor lawyers as leaders in their respective fields; 12 attorneys were recognized nationally and 10 were ranked in the top band.
March 08, 2015
Mark Gallant, co-chair of the firm's Health Care practice group, is quoted in the New York Times in an article discussing the impact of a 2012 argument against the health care law in the supreme court, and how that is effecting current medicaid expansion.
January 20, 2015
In an article titled ''Why the Supreme Court's Medicaid Decision Matters,'' Mark Gallant, co-chair of the firm's Health Care Group, comments on Medicaid providers and how a recent Supreme Court hearing could affect issues at the state and federal level.
July 09, 2014
Cozen O’Connor continues to strengthen its focus on health care with the recent hiring of R. Christopher Raphaely, who will serve as co-chair of the firm’s Health Care Practice Group. Previously deputy general counsel for the Jefferson Health System, and general counsel to the system’s accountable care organization and captive professional liability insurance companies, Raphaely will be resident in the Philadelphia office.
May 30, 2014
Chambers USA recognized 29 Cozen O’Connor lawyers as leaders in their respective fields; six attorneys were recognized nationally and eight were ranked in the top band. Stanley Sher was named a “Senior Statesman” in the “Transportation: Shipping: Regulatory (outside New York)” industry, for the pivotal role Sher plays in the firm’s continued success in the transportation industry.
May 13, 2014
Mark Gallant, chair of the Health Care Group, was recently mentioned in a Law360 article about his victory on behalf of CardioNet and LifeWatch Services in the 3rd Circuit.
January 24, 2014
In an article titled “Cigna Coverage Row Shouldn’t Be Arbitrated, 3rd Circ. Told,” Mark Gallant (Health Care, Philadelphia) discusses how a Pennsylvania federal judge wrongly forced two cardiac telemetry manufacturers to arbitrate their claims that Cigna Health Corp. violated federal pension laws and unfair competition laws when it decided to stop covering the devices. Mark, who’s representing CardioNet Inc. and LifeWatch Services Inc., told a three-judge panel that claims his clients brought against the insurer under the Employee Retirement Income Security Act and for trade disparagement did not fall under the terms of a provision in the contract the companies inked with Cigna requiring that the parties arbitrate any disputes over interpretations of the deal or any alleged breaches.
November 06, 2013
Mark Gallant, chair of the Health Care Practice Group, and Robert Chu, of the Health Care Practice Group, were recently mentioned in a Law360 article for representing UPenn Health Systems.
August 28, 2013
Forty-six Cozen O’Connor lawyers from eight of the firm’s national offices have been selected for inclusion in The Best Lawyers in America. Attorneys were selected based on a rigorous peer-review of more than 4.3 million detailed evaluations. The list will be included in publications such as The Washington Post, Los Angeles Times, and New York magazine.
July 11, 2013
Earlier this year, Mark Gallant was quoted in a Law360 article titled, "Hospitals Scramble As ACA Gives Patients Pricing Leverage". Mark Gallant, of the Health Care Practice Group, was quoted as saying "The charges are a problem, but they’re also a symptom of another problem, which is the unevenness of the payments and the need to rob Peter because you're not getting paid by Paul,” said Mark H. Gallant, chairman of the health group at Cozen O'Connor". To read more of Mark Gallant’s remarks, as well as the full article, click here.
May 31, 2013
In an article titled, "Hospitals Scramble As ACA Gives Patients Pricing Leverage", Mark Gallant of Health Care Group is quoted regarding the costs that uninsured patients may face as hospitals apply a form of "balance billing" to make up for lower reimbursements from insurers and government payors. Gallant was quoted as saying, "The charges are a problem, but they’re also a symptom of another problem, which is the unevenness of the payments and the need to rob Peter because you're not getting paid by Paul"
March 07, 2013
Attorneys Mark Alderman, Mark Gallant, Colin Roskey and Howard Schweitzer are highlighted in this article on Cozen O'Connor's growth in the Health Law and Public Strategies Groups.
February 01, 2013
Mark Gallant, a member of the firm, and chair of the Health Law practice group, was quoted in Of Counsel: The Legal Practice and Management Report, in an article titled, “Affordable Care Act, Changing Demographic, Consolidation All Fueling Health Care Law.”
March 29, 2012
Mark Gallant and Iden Martyn were featured in Bloomberg BNA's Health Care Daily Report article entitled ''Medicare: Court Finds Notice of Deadline Inadequate, Orders Payment of Medical Education Claims.''
February 09, 2011
Forty-three Cozen O’Connor lawyers from six of the firm’s national offices have been selected for inclusion in the 2011 edition of The Best Lawyers in America. Lawyers were selected for inclusion in the 2011 edition based on a rigorous peer–review of more than 3.1 million detailed evaluations.
September 29, 2009
Forty-two Cozen O’Connor attorneys from seven of the firm’s national offices have been selected for inclusion in the 2010 edition of The Best Lawyers in America.
May 28, 2009
Cozen O’Connor is proud to announce that 52 attorneys from the firm’s Philadelphia and West Conshohocken offices have been named 2009 Pennsylvania Super Lawyers by Law & Politics, and will appear in the June 2009 issues of Philadelphia magazine and Pennsylvania Super Lawyers.
October 29, 2008
Twenty-five Cozen O’Connor attorneys from six of the firm’s national offices have been selected for inclusion in the 2009 edition of The Best Lawyers in America.
May 29, 2008
Cozen O’Connor is proud to announce that 42 attorneys from the firm’s Philadelphia and West Conshohocken offices have been named 2008 Pennsylvania Super Lawyers by Law & Politics, and will appear in the June 2008 issues of Philadelphia magazine and Pennsylvania Super Lawyers.
Publications
June 22, 2018
Mark Gallant, Robert Chu, and Greg Fliszar all of Cozen O'Connor's Health Law group, co-authored the chapter titled, “Medicaid Managed Care” contained in Thomson Reuters’ newly released Health Law Handbook 2018 Edition.
January 25, 2018
As a first in the history of the Medicaid program, the Centers for Medicare & Medicaid Services (CMS) approved, on January 12, 2018, Kentucky’s section 1115 waiver application that imposes on many beneficiaries a “community engagement” requirement as a condition of Medicaid eligibility. This is...
December 01, 2017
Since 1973, the Social Security Act has mandated that states provide retroactive Medicaid benefits for three months prior to the individual’s application. SSA § 1902(a)(34). Congress enacted this provision to provide coverage to those lacking knowledge about their Medicaid eligibility and to those...
January 02, 2017
Mark Gallant discusses the Medicaid outlook for 2017 in the AHLA newsletter AHLA Connections.
August 01, 2016
Mark Gallant and Ryan Blaney discuss key issues for hospital and health care professionals in the AHLA Representing Hospitals and Health Systems Handbook.
May 15, 2015
In an article titled "Provider Suits Over Medicaid Rates," Mark Gallant discusses the recent Supreme Court decision in Armstrong v. Exceptional Child Center, Inc.
March 03, 2015
On February 23, 2015, the District Court in Baney v. Fick held that a patient’s complications arising from elective surgery do not fall under the purview of the Emergency Medical Treatment and Labor Act, 42 U.S.C. § 1395dd, (EMTALA). See 2015 BL 45710, M.D. Pa., No. 4:14-cv-2393 (Feb. 23, 2015). Plaintiffs, a husband and wife, alleged that the medical team managing Brian Baney’s care at Mount Nittany Medical Center should have immediately arranged for his transport to another hospital when he received an esophageal injury following an elective neurosurgical procedure at Mount Nittany Medical Center, and that the team’s care of Baney amounted to a failure to properly stabilize and properly manage Baney’s injury as required under EMTALA. However, the Baney court (citing to Torretti v. Main Line Hospitals, Inc., 580 F.3d 168, 174-75, 177 (3d Cir. 2009), dismissed the plaintiffs’ EMTALA claim with prejudice because the claim “did not fit within EMTALA’s scope.”
September 03, 2014
With little fanfare just before the Labor Day weekend, CMS announced a program in which it would enter into administrative agreements with eligible providers in exchange for the providers’ withdrawal of pending appeals (“Settlement Process”). This announcement follows massive backlogs in...
April 23, 2013
Two of Mercy Health System’s hospitals (Nazareth Hospital and the former St. Agnes Medical Center) successfully challenged, before Judge Ludwig of the U.S. District Court for the Eastern District of Pennsylvania, the Secretary of Health and Human Services’ exclusion of days of care provided to Pennsylvania’s General Assistance (GA) patients in fiscal year 2002 from the formula used to determine the hospitals’ Medicare disproportionate share hospital (DSH) payments (Nazareth Hosp. v. Sebelius, E.D. Pa. No. 2:10-cv-03513-EL, April 8, 2013). The exclusion resulted in lower Medicare DSH payments.
October 24, 2012
Seventh Circuit Rules that Medical Necessity Trumps State-Imposed Cap on "Optional" Medicaid Coverage - Health Law Alert - In a class action lawsuit, the U.S. Court of Appeals for the 7th Circuit recently affirmed a lower court decision granting a preliminary injunction that prevented the state of Indiana from enforcing a $1,000 annual cap on Medicaid coverage for medically necessary dental services, and concluded the cap most likely violated rights granted to Medicaid beneficiaries under federal law. Bontrager v. Indiana Family and Social Services Administration, 2012 U.S. App. LEXIS 20157 (September 26, 2012).
July 05, 2012
In a heavily anticipated landmark ruling, the Supreme Court has upheld the constitutionality of the so-called “individual mandate” of the Affordable Care Act – i.e., the requirement that those not insured privately, through their employer or through a governmental program, must either purchase...
June 28, 2012
Supreme Court Rules on Affordable Health Care Act: Upholds Individual Mandate and Limits Scope of Medicaid Expansion - Health Law Alert - In a heavily anticipated landmark ruling, the Supreme Court has upheld the constitutionality of the so-called “individual mandate” of the Affordable Care Act – i.e., the requirement that those not insured privately, through their employer or through a governmental program, must either purchase minimum essential health insurance coverage or pay a “penalty” for failing to do so.
February 21, 2012
CMS Issues Proposed Rule on Reporting and Returning Medicare Overpayments - Health Law Alert! - On February 16, 2012, the Centers for Medicare & Medicaid Services (CMS) issued a widely anticipated proposed rule (the proposed rule) implementing the statutory requirement of Section 6402(a) of the Affordable Care Act (the ACA) that providers and
suppliers report and return overpayments from Medicare and Medicaid.
March 23, 2011
On First Anniversary, a Look at Challenges to Health Care - The Legal Intelligencer - On its one-year anniversary, the sweeping health care reform law — referred to as the "Affordable Care Act" (ACA) if you like it, and "Obamacare" if you don't — is embroiled in litigation. Its fate, like that of the 2000 presidential election, is likely to be determined by the Supreme Court.
November 17, 2010
CMS Voluntary Self-Referral Disclosure Protocol: The Good, The Bad, and The Ugly - Health Law Alert! - On September 23, the Centers for Medicare & Medicaid Services (CMS) released the much anticipated Medicare self-referral disclosure protocol (SRDP). CMS was required to establish the SRDP by Section 6409 of the Affordable Care Act (ACA), which obligated the Secretary of Health and Human Services to inform providers and suppliers how to self-disclose actual or potential violations of the Stark law.
May 12, 2010
Stark Realities of Health Care Reform - Health Law Alert! - Our Health Law Alert of April 26, 2010 summarized recent amendments to the Anti-Kickback Statute (“AKS”) concerning “reverse” federal false claims act (“FCA”) and the implications of the requirement of Section 6402 of the Patient Protection and Affordable Care Act of 2010, Pub. L. No. 111-148 (the “PPACA”) to report and refund “overpayments” by Medicare and Medicaid within sixty (60) days of “identification.” An “overpayment” is defined to
May 11, 2010
Health Care Reform Includes Reporting Requirements Regarding Drug and Device Manufacturers' Payments to Physicians and Teaching Hospitals - Health Law Alert! - The Patient Protection and Affordable Care Act (the “PPACA”) of 2010 as amended by the Health Care and Education Reconciliation Act of 2010 (the “Reconciliation Act”) (collectively referred to as “the Health Care Reform Act”) includes a number of new reporting requirements designed to enhance the transparency of certain segments of the health care industry including manufacturers of drugs, medical devices, biologicals and medical supplies.
April 26, 2010
Providers Beware: Health Care Reforms Make Failing to Promptly Refund Overpayments—Including Those Attributable to Identified Stark Violations—Potential False Claims Act Violations - Health Law Alert! - By linking the retention of program overpayments and potential liability under the False Claims Act (FCA), the Patient Protection and Affordable Care Act of 2010 (PPACA) has dramatically expanded the scope of exposure for health care providers under the FCA. Potential overpayments to providers—including but not limited to such things as garden variety duplicate payments to discoveries of Medicare payments for designated health services (DHS) provided on referrals from
March 23, 2010
Highmark, Inc. Challenges PA. Insurance Department Investigation - Health Law Alert! - Highmark, Inc. has filed a lawsuit in the Commonwealth Court of Pennsylvania challenging the legality of an ongoing Pennsylvania Insurance Department investigation involving potential anticompetitive conduct and/or unfair trade practices by Pennsylvania’s Blue Cross and Blue Shield companies.
July 09, 2009
New Jersey Enforces Limits on Overpayment Recoveries - Health Law Alert! - The New Jersey Commissioner of Banking and Insurance
issues Enforcement Notice requiring Insurer to cease and
desist from attempting to recoup overpayments based on
improper extrapolations and to reimburse providers for
amounts improperly obtained.
July 07, 2009
Recent Pennsylvania Decision Requires Disclosure of Medicaid Managed Care Rates - Health Law Alert! - Commonwealth Court holds that provider agreements with
Medicaid managed care plans, including the negotiated
payment rates contained in those agreements, are subject to
disclosure under the Pennsylvania Right to Know Law.
February 04, 2008
Update: Pennsylvania Hospitals to Pay For Medical Mistakes – Quality of Care At The Forefront - Health Law Alert! - Prevention of medical mistakes is a cause celebre, and states are beginning to jump
on the so-called “never event” bandwagon. Taking a highly proactive stance,
Governor Edward G. Rendell recently announced that Pennsylvania acute-care
general hospitals will not be reimbursed by the state Medicaid program for services
resulting from medical errors. On January 14, 2008, Pennsylvania became just the
February 23, 2006
HIGHLIGHTS OF THE DEFICIT REDUCTION ACT OF 2005 - Health Law E-lert! -
Events & Seminars
Past Events
December 04, 2019
- Philadelphia, PA
November 17, 2019
- Chicago, IL
October 30, 2019
- Philadelphia, PA
March 12, 2019
- Philadelphia, PA
March 13, 2018
- Philadelphia, PA
March 15, 2017
- Baltimore, MD
March 07, 2017
- Philadelphia, PA
December 07, 2016
- Philadelphia, PA
April 13, 2016
- Baltimore, MD
March 15, 2016
- Philadelphia, PA
March 25, 2015
- Baltimore, MD
March 12, 2015
- Philadelphia, PA
December 03, 2014
- Philadelphia, PA
March 26, 2014
- Baltimore, MD
March 13, 2014
- Philadelphia, PA
February 06, 2014
- Philadelphia, PA
October 27, 2013
- Los Angeles, CA
May 09, 2013
- Philadelphia, PA
March 20, 2013
- Baltimore, MD
March 12, 2013
- Philadelphia, PA
February 06, 2013
- Philadelphia, PA
November 05, 2012
- Live Webcast
March 28, 2012
- Baltimore, MD
March 13, 2012
- Philadelphia, PA
March 15, 2011
- Philadelphia, PA
February 08, 2011
- Philadelphia, PA
October 14, 2010
- Webinar via Internet
September 21, 2010
- Philadelphia, PA
September 16, 2010
- Webinar
June 23, 2010
- New York, NY
May 26, 2010
- Philadelphia, PA
March 11, 2010
- Philadelphia, PA