John R. Jacob is the leader of the firm’s health practice and a member of the regulatory practice steering committee.

Mr. Jacob represents multihospital health care systems, major academic medical centers, device manufacturers and health technology companies. He has extensive experience in counseling, compliance, reimbursement and litigation regarding Medicare and Medicaid regulatory and policy matters. He advises health industry entities on a wide range of reimbursement and compliance issues; legislative and regulatory policy analysis and advocacy; potential fraud and abuse and overpayment matters and disclosures; federal investigations; and due diligence and strategic analysis associated with health care business arrangements.

With a particular focus on complex Medicare reimbursement compliance and coverage disputes, Mr. Jacob has practiced extensively before federal and state courts and administrative tribunals, including the Department of Health and Human Services’ (HHS) Provider Reimbursement Review Board (PRRB).

Practice & Background

Mr. Jacob advises hospitals, device manufacturers and other health industry entities on the numerous regulatory and policy issues they face in their daily operations, including reimbursement counseling; legislative and regulatory policy analysis, drafting and advocacy; potential fraud and abuse and overpayment matters; voluntary disclosures; and federal investigations. Mr. Jacob has extensive experience representing clients as they attempt to navigate the new rules and requirements imposed under the Affordable Care Act, including the “employer mandate” provisions for large employers.

Mr. Jacob was one of four court-appointed “Plaintiffs’ Coordinating Counsel” (PCC) for In Re Medicare Reimbursement Litigation, a consolidated litigation, which included almost 300 cases and almost 700 hospitals challenging their Medicare disproportionate share hospital (DSH) payments. In March 2008, after more than three years of litigation and almost two years of complex settlement negotiations with the Department of Justice and the Department of Health and Human Services Office of General Counsel, the parties reached an historic settlement with the Medicare Program that paid the hospitals $666,125,000 in overdue Medicare payments. At the time, this was the single largest reimbursement settlement in the history of the Medicare Program, and besides being a PCC for the litigation, Mr. Jacob was the lead negotiator of this settlement on behalf of all of the plaintiff-hospitals.

Before joining Akin Gump, Mr. Jacob was a law clerk with the attorney general of Maryland at the Maryland State Police Headquarters.

Mr. Jacob served as the hiring partner for the firm’s Washington, D.C. office from 2008-16.  He is a member of the firm’s and the Washington office’s pro bono committees, as well as the Washington office practice management, hiring, associates and diversity committees. Mr. Jacob was nationally ranked as a top health care lawyer in the 2008-2016 editions of Chambers USA: America’s Leading Lawyers for Business. Nightingale’s Healthcare News named him as one of the Outstanding Healthcare Litigators for 2008; in 2005, the same publication also named him as one of the Outstanding Young Healthcare Lawyers of the year. He has been named as a Washington, D.C. “Super Lawyer” each year since 2012. He served as the executive editor of the American University Law Review.

Representative Matters

Mr. Jacob’s recent representations include:

  • representing hospitals in group appeals at the PRRB, challenging the exclusion of Medicare-Medicaid dual-eligible patient days from the Medicare DSH calculation
  • counseling clients on the implications, risks and business strategies regarding the ACA mandate on large employers to provide health insurance to their full-time employees
  • representing major Prospective Payment System-exempt dedicated cancer center with TEFRA (Tax Equity and Fiscal Responsibility Act) adjustment requests before the MAC (Medicare Administrative Contractor) and Centers for Medicare and Medicaid and with appeals before the PRRB
  • representing device manufacturer with Medicare, privacy and other compliance issues
  • representing groups of California hospitals before the PRRB challenging the statewide application and calculation of the rural floor budget neutrality adjustment
  • providing compliance and privacy counsel to the nation’s largest e-prescription network
  • representing hospitals in appeals to the PRRB on several aspects of the Medicare payment calculations for Graduate Medical Education (GME) and Indirect Medical Education (IME), including resident counts, research time, training in unapproved programs, base year average per resident amounts and bed counts
  • representing 70 hospitals in lead cases on mandamus claims requiring HHS to reopen and revise prior erroneous DSH payment determinations excluding Medicaid-eligible but unpaid days
  • representing hospitals with Medicare volume adjustments, sole community hospital status and other Medicare waivers.

Community Involvement

Mr. Jacob is involved in community, civic and charitable activities that include being:

  • president of the Board of Directors of the Washington Legal Clinic for the Homeless
  • member of the Finance and Fund Development committees of the board of directors and a member of the Leadership Council of the Convergence Center for Policy Resolution, a nonprofit organization focused on achieving widely supportable solutions to major policy challenges
  • a member of the American Health Lawyers Association
  • a member of the D.C. Bar Association’s Health Law Section
  • member of the American University, Washington College of Law, Health Law and Policy Program Advisory Council
  • member of the Leadership Greater Washington Class of 2018.

Awards & Accolades

  • recognized by Washingtonian magazine as a top lawyer in the category of health care (2013)
  • ranked in the Healthcare category by Chambers USA: America’s Leading Lawyers for Business (2008–2017)
  • recognized by Super Lawyers in the health care practice area (2012–2016).

Speaking Engagements

  • A Health-y Environment: Avoiding Environmental Liability at Health Care Facilities,” Akin Gump hosted webinar, (September 28 2017)
  • “Affordable Care Act: How it Impacts Your Employees & Your Organization's Bottom Line,” National Automatic Merchandising Association (NAMA) Webinar (July 24, 2013)
  • “Affordable Care Act—Impact on Employers in 2013 and Beyond,” Akin Gump Strauss Hauer & Feld LLP Webinar (May 14, 2013)
  • “It’s Here! The ‘Employer Mandate’ Provisions of the Affordable Care Act (ACA),” Texas Association for Home Care & Hospice Executive Leadership Forum (May 7, 2013)
  • “Disproportionate Share Hospital Reimbursement,” American Health Lawyers Association webinar (April 30, 2013)
  • “Affordable Care Act—Impact on Employers in 2013 and Beyond,” Akin Gump Strauss Hauer & Feld LLP CLE Program (March 14, 2013)
  • “Recent Developments Regarding the Medicare DSH Adjustment,” American Health Lawyer’s Association, Institute on Medicare and Medicaid Payment Issues (March 28-30, 2012)
  • “The Medicare DSH Adjustment,” American Health Lawyer’s Association, Institute on Medicare and Medicaid Payment Issues (March 30-April 1, 2011)
  • “The Twin Peaks of DSH: Rulings 1498 and Healthcare Reform,” American Health Lawyers Association webinar (February 22, 2011)
  • “Medicare DSH Adjustments,” American Health Lawyer’s Association, Institute on Medicare and Medicaid Payment Issues (March 24-26, 2010)
  • “Why Health Law Could Save Your Career,” American University’s Washington College of Law (January 21, 2010).