Stephanie Webster’s practice focuses on the area of Medicare and Medicaid reimbursement. She counsels hospitals regarding payment and compliance, and represents them in administrative and federal court litigation. Ms. Webster formerly served as an attorney for the Centers for Medicare and Medicaid Services (CMS), Division of the Office of General Counsel for the U.S. Department of Health and Human Services (HHS). She has been recognized as a leading health care lawyer by Chambers USA and Nightingale’s Healthcare News.

Examples of Ms. Webster’s engagements include—

• regularly advising hospitals on disproportionate share hospital (DSH), graduate medical education (GME), bad debt, geographic reclassification and a variety of other regulatory, compliance, and appeal  issues involving Medicare and Medicaid payment
• serving as co-counsel in thousands of appeals for more than 700 hospitals in challenges to a Medicare budget neutrality factor applied to Medicare prospective payment system (PPS) rates to account for the impact of the wage index rural floor, including the lead case that successfully overturned the government’s erroneous methodology, Cape Cod Hospital v. Sebelius, 630 F.3d 203 (D.C. Cir. 2011)
• litigating lead case challenging CMS policy of including Part C Medicare Advantage days in the DSH SSI fractions after 2004
• representing hospitals challenging the exclusion of Tennessee waiver days from the Medicare DSH calculation in the 6^th Circuit Court of Appeals
• serving as co-counsel in litigation challenging the validity of CMS Ruling CMS-1498-R
• advising and representing clients in Medicare coverage appeals
• counseling clients on compliance questions involving the 340B drug discount program
• representing hospitals in disputes involving denial of sole community hospital status
• representing hospital in challenge to written agreement requirement for including rotations to outpatient dental clinics in Medicare GME resident counts
• counseling transplant center in connection with federal investigation of off-label drug prescribing practices
• representing health system in administrative and federal court challenges to retrospective correction of rehabilitation facility outlier payments
• advising children’s hospitals on Medicaid DSH and supplemental payment questions
• negotiating a favorable settlement for a large teaching hospital in multi-year appeals challenging the denial of Medicare reimbursement for medical education costs incurred for residents’ training in primary care settings
• providing legal and strategic advice to healthcare providers with Recovery Audit Contractor (RAC) and Medicaid Integrity Contractor (MIC) audit issues and appeals
• serving as co-counsel in the first cases ever decided by the Provider Reimbursement Review Board (PRRB) and federal district court requiring the correction of systemic errors in the calculation of the Medicare/SSI fractions that determine DSH payments to hospitals (Baystate Medical Center v. Leavitt, 5454 F.Supp.2d 20, amended, 587 F. Supp.2d 37 (D.D.C. March 31, 2008))
• obtaining the first decision from the PRRB overturning the exclusion of labor and delivery days from the Medicare DSH payment calculation
• playing key role in the lead of 270 federal court actions to compel the reopening of DSH payment determinations for more than 600 hospitals, which included defeating the U.S. Solicitor General’s petition for review of a D.C. Circuit decision that created a circuit split on a key Medicare reimbursement question and was alleged by the government to involve $2.8 billion (In Re Medicare Reimbursement Litigation, Baystate Health System, et al. v. Thompson, 309 F.Supp.2d 89 (D.D.C. 2004), aff’d, 414 F.3d 7 (D.C. Cir. 2005), cert. denied, 126 S. Ct. 1672 (2006))
• securing multi-million dollar settlement for leading academic medical center for GME payments stemming from training of physicians in advanced medical fellowships
• representing a children’s hospital in the first and only proceeding before the PRRB involving payment under the Children’s Hospital GME Program.

Ms. Webster is the recipient of numerous awards and recognition for her work, including—

• Chambers USA: America’s Leading Lawyers for Business in Health Care
• Washington, D.C. “Super Lawyer,” 2012
• “Outstanding Healthcare Litigators,” Nightingale Healthcare News, 2004
• CMS Administrator’s Award for achievement and dedication in work on the State Children’s Health Insurance Program (SCHIP) regulation
• Outstanding Law Student Award by the National Association of Women Lawyers
• C. Willis Ritter Endowed Scholarship, University of Virginia School of Law.

Ms. Webster is active in a number of health care and legal organizations, including the American Health Lawyers Association (co-chair, Children’s Hospital Affinity Group of the In-house Counsel Practice Group), Healthcare Financial Management Association, American Bar Association and Women’s Bar Association of the District of Columbia. She serves on the Advisory Board of the Bureau of National Affairs Medicare Report and is a frequent author and presenter on health care topics.

Publications

• “Providers Rack Up RAC Wins: CMS Reports 64% RAC Appeals Decided in Providers’ Favor,” Dennis Barry’s Reimbursement Advisor, Vol. 26, No. 1, September 2010 (co-author)
• “CMS Issues Proposed Reimbursement Changes for Acute-Care Inpatient Hospitals and LTCs for FY 2011”, American Health Lawyers Association Alert to Members of Regulation, Accreditation, and Payment Practice Group (April 2010) (co-author)
• “New Requirements for Government Reporting of Personal Injury Settlements Gives Teeth to Medicare Secondary Payer Rules Beginning in 2010, American Health Lawyers Association Healthcare Liability and Litigation Practice Group, Health Briefs E-Newsletter (January 2010)
• 2007 SSI Fraction Reduces Medicare DSH Payments for Many Hospitals,” Dennis Barry’s Reimbursement Advisor, Vol. 25, No. 3, November 2009 (co-author)
• “340B Program Presents Opportunities–and Challenges,” Healthcare Financial Management, Vol. 63, No. 11, November 2009 (co-author)
• “Location, Location, Location: Medicare Observation Bed Policy,” Dennis Barry’s Reimbursement Advisor, Vol. 24, No. 9, May 2009 (co-author)
• “Medicare DSH Hospitals and SCHIP Expansion: Providers Should Study SCHIP Program Details,” Dennis Barry’s Reimbursement Advisor, Vol. 24, No. 8, April 2009
• “D.C. Circuit Decision in Adena: The Unclear Future of Charity Care Days in the Medicare DSH Calculation,” Dennis Barry’s Reimbursement Advisor, Vol. 24, No. 1, September 2008
• “Grasping Recent Changes to the PRRB Appeal Process,” Healthcare Financial Management, Vol. 62, No. 8, August 2008 (co-author)
• “Court Rules in Hospital’s Favor in DSH SSI Case,” Dennis Barry’s Reimbursement Advisory, Vol. 23, No. 10, June 2008
• “Medicare Part C Days: CMS Attempts (Again), To Put Policy Into Practice,” Dennis Barry’s Reimbursement Advisor, Vol. 23, No. 2, October 2007
• “Why Medicaid GME Funding Should Be Preserved,” Healthcare Financial Management, Vol. 61, No. 9, September 2007 (co-author)
• “Teaching Hospitals and Payment for Residents and Fellows; Medical Education Payments,” Health Care Financial Management, Vol. 60, No. 3, March 2006 (co-author)

Presentations

• The New PRRB Rules: Tips to Avoid Common Pitfalls, American Health Lawyers Association Institute on Medicare and Medicaid (March 2011, March 2012)
• Healthcare Reform and the 340B Drug Discount Program: Expanded Eligibility and Expanded Compliance Risks, American Health Lawyers Association Webinar (November 2010)
• It’s Not Child’s Play: Special Considerations for Pediatric Medicine and Research, Current Issues Relating to Off-Label use of Drugs and Devices in Children, American Health Lawyers Association Conference on Legal Issues Affecting Academic Medical Centers and Other Teaching Institutions (January 2010)
• Medicare, Medicaid, and SCHIP Extension Act: What All Lawyers and Their Clients Must Know About the Act Before Settling a Personal Injury Claim, West National Online Conference (November 2009)
• New Rules Governing PRRB Appeals, Healthcare Financial Management Association–National (December 2008)
• New Rules Governing PRRB Appeals, Healthcare Financial Management Association–Puerto Rico Chapter, Healthcare Integration Medicare Update Seminar (August 2008)
• New PRRB Appeal Rules: Effect on Providers, Healthcare Financial Management Association Audio Webcast (July 2008)

Ms. Webster is a member of the Virginia, Texas and District of Columbia bars. She received her B.A. cum laude from Yale University in 1990 and her J.D. from the University of Virginia in 1994.