- Obtained coverage of wound care products in recently finalized Medicare local coverage determinations (LCDs), solving an existential threat to the client’s business.
- Counsel for health care providers and suppliers on compliance with the CARES Act Provider Relief Fund requirements.
- Assisted health care entities in obtaining more than $100 million in previously denied Provider Relief Fund payments.
- Advising health care providers with single audit findings and in response to demands from HRSA.
- Legislative and regulatory counsel for state and national health care trade associations, hospitals, and provider groups on federal coverage and reimbursement requirements.
- Counsel for providers and suppliers participating in alternative payment models and delivery system reform initiatives.
- Legislative and regulatory counsel for innovative technology manufacturers, including one of the leading diabetes care technology companies, on CMS coverage and reimbursement issues.
- Counsel for health care providers undergoing congressional investigations.
- Co-hosted Alston & Bird’s multipart series on HRSA’s Provider Relief Fund (PRF), advising health care providers on how to properly obtain payments for lost revenue during the pandemic and how to be prepared and respond to government audits.
Partner,
- Phone: +1 202 239 3818
- Email: brian.lee@alston.com
Brian offers solution-driven guidance and strategies to health care clients for regulatory and legislative issues. As a former consultant advising on congressional and administrative action, he has an edge when providing counsel to clients on federal reimbursement policies and federal regulations.
Brian Lee focuses his practice on regulatory and legislative issues concerning federal reimbursement for and regulation of physicians, hospitals, post-acute care providers, insurers, and manufacturers.
Brian has helped numerous clients secure more than $200 million in pandemic-related Provider Relief Funds. He has also advised them through subsequent reporting periods and on how to prepare for related government audits.
Brian also assists clients in navigating Medicare coverage and reimbursement requirements and Medicare payment policies. He provides counsel on the development and implementation of strategic initiatives in response to congressional and administrative coverage and reimbursement changes.
Before joining Alston & Bird, Brian served as a consultant for a health care policy research and management consulting firm, where he advised CMS on congressional action and their impact on Medicare, counseled on Medicare reimbursement issues, and developed methods to assess, review, and evaluate alternative payment models, including changes that waive the Anti-Kickback Statute and Stark Law. Brian also served as a Medicare denial appeals attorney, obtaining reimbursement for inappropriately denied Medicare Part A services. Super Lawyers named Brian to its Rising Stars list for health care law in 2019. The Best Lawyers in America® named Brian to its “Ones to Watch” list for health care law in 2021 and 2022.
Bar Admissions
- District of Columbia
- Massachusetts
Education
- Harvard University (M.P.H., 2013)
- University of Maryland (J.D., 2012)
- Georgetown University (B.S., 2009)
Memberships
- Korean-American Bar Association of Washington, D.C.
- The Network for Public Health Law
Healthy Byte | The Extension of Virtual Direct Supervision
Sean Sullivan, Tania Khan, and Brian Lee explain “incident to” rules, the extension of virtual direct supervision flexibilities, and which services would be affected by the proposals.Healthy Byte | New Codes for Advanced Primary Care Management Services and Digital Mental Health Treatment Devices
Sean Sullivan, Tania Khan, and Brian Lee discuss the new G-codes for APCM and their relationship to other care management services like chronic care management (CCM), the similarities between DMHT and remote therapeutic monitoring (RTM) codes, and the likelihood of more categories coming to expand coverage of other digital therapeutics.Healthy Byte | How Is Federal Policy Keeping Up with AI?
Tim Trysla and Brian Lee discuss Washington’s approach so far to regulating AI, including which health care agencies have taken steps, and how health care entities with assets in the AI space can prevent surprises as regulations are finalized.Healthy Byte | HHS Proposes Rule to Disincentivize Information Blocking for Health Care Providers
Sean Sullivan, Elinor Hiller, and Brian Lee discuss the context for these new proposed disincentives, what’s in the proposed rule, what the effect could be on providers, and the deadline for public comments.Healthy Byte | Congress and White House Grapple with Regulating Artificial Intelligence
Jane Lucas and Brian Lee discuss how congressional leaders are looking at regulating AI to address myriad issues, including bias and data privacy concerns, as well as how different agencies are already playing a role in areas like medical device regulations and protecting patient health information.Healthy Byte | Guidance on Virtual Direct Supervision from CMS and Medicare
Sean Sullivan and Brian Lee discuss how the extended public health emergency adds a “virtual” wrinkle to direct supervision through 2023 and how supervising physicians need to be available should they be needed.Healthy Byte | Provider Relief Fund (PRF) Rolls On with Reporting Period 3
Brian Lee and CJ Frisina discuss reporting deadlines, the latest guidance from HRSA, what to expect in terms of oversight and audits, and best practices on how to prepare for the inevitable audit.