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William T. Mathias

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Bill Mathias is the co-chair of Baker Donelson's Fraud and Abuse Team within the Health Law practice.

Featured Videos

Stark and Anti-Kickback Proposed Rules: Understanding the Proposals and Their Potential Impact October 21, 2019
Imminent Mandatory Compliance Program Deadline June 12, 2019

Featured Experience

Assisted large, national for-profit health system in vetting fraud & abuse and Stark issues in multiple clinical co-management arrangements designed to improve quality and enhance hospital/physician alignment.

Led health care regulatory due diligence team for Fortune 20 company in connection with multiple stock acquisitions valued upwards of $60 million.

Advised multiple, large, for-profit and not-for-profit health systems in analyzing fraud & abuse risks associated with their supply chain management and purchasing strategy, including compliance with the discount and group purchasing organization (GPO) safe harbors.

Professional Biography

Overview

Mr. Mathias represents clients across the country in all areas of the health care industry, with a focus on fraud and abuse, internal and government investigations and corporate compliance matters.

Bill has extensive experience counseling clients on compliance with the federal Anti-kickback Law, the Stark Physician Self-Referral Statute and the federal Civil Monetary Penalty provisions. With the changing nature of the health care system, Bill works with hospitals and health care systems to develop physician alignment strategies, including joint ventures, co-management agreements, and gainsharing arrangements. He also advises health systems and GPOs on compliance with the discount and GPO safe harbors as well as strategies for reducing legal risks associated with cutting edge supply chain management and purchasing programs.

Bill regularly works with investors and health care companies to evaluate potential opportunities, identify risks and structure transactions in an effort to mitigate risk. He directs health care due diligence efforts for clients and transactions counsel. Bill conducts internal investigations; defends against government investigations and qui tam false claims cases. He has extensive experience working with clients to resolve matters through the OIG and CMS voluntary self-disclosure protocols. Bill has successfully obtained several OIG advisory opinions. He also has experience advising health care providers facing exclusion from Medicare and other federal health care programs as well as health care companies that have employed excluded providers.

Over the years, Bill has gained significant experience in negotiating Corporate Integrity Agreements (CIAs) and helping health care companies to navigate the complexities of operating under a CIA. In addition, he regularly assists clients with developing and monitoring the effectiveness of compliance programs.

Bill has a deep understanding of the reimbursement, licensing and compliance issues affecting DME/HME suppliers, pharmacies, infusion companies and other "Part B" suppliers. He has assisted suppliers in addressing issues under the DMEPOS Competitive Bidding Program. He also works with companies on compliance strategies under the Physician Payment Sunshine Act and the CMS Open Payments Program.

Mr. Mathias is a national leader on health care fraud and abuse and compliance matters. In 2008, he was selected by Nightingale's Healthcare News as an "Outstanding Healthcare Fraud and Compliance Lawyer." He is a past vice chair of the American Health Lawyers Association's Fraud & Abuse Practice Group and the American Bar Association Health Law Section's Business & Transactions Interest Group.

Representative Matters
  • Assisted large, national for-profit health system in vetting fraud & abuse and Stark issues in multiple clinical co-management arrangements designed to improve quality and enhance hospital/physician alignment.

  • Led health care regulatory due diligence team for Fortune 20 company in connection with multiple stock acquisitions valued upwards of $60 million.

  • Advised multiple, large, for-profit and not-for-profit health systems in analyzing fraud & abuse risks associated with their supply chain management and purchasing strategy, including compliance with the discount and group purchasing organization (GPO) safe harbors.

Professional Honors & Activities

Professional Memberships

  • Member – American Bar Association
    • Health Law Section
      • Vice Chair, Planning Committee, Emerging Issues in Healthcare Law Conference (2017 – present) 
      • Vice Chair, Business & Transactions Interest Group (2009 – 2012) 
  • Member – American Health Lawyers Association
    • Fraud & Abuse Practice Group
      • Vice Chair (2008 – 2014)
      • Advisory Opinion Task Force (2004 – 2008)
    • Mentoring Program
    • Public Interest Contributor
  • Member – Maryland State Bar Association
  • Member – Serjeants Inn Law Club
  • Permanent Member – United States Court of Appeals, Fourth Circuit Judicial Conference

Community Service

  • Young Lawyers Division, Past Board Member – Legal Aid Bureau

Honoraries

  • Listed in Expert Guides to the Leading Lawyers – Best of the Best USA, Healthcare Category (2014)
  • Listed in Maryland Super Lawyers, Health Care (2012 – 2014)
  • Selected by Nightingale's Healthcare News as an "Outstanding Healthcare Fraud and Compliance Lawyer" for 2008 and an "Outstanding Young Healthcare Lawyer" (2003)
Professional Background
  • Law Clerk, the Honorable Judge Joseph H. Young, United States District Court for the District of Maryland
  • Summer Associate, Goodsill, Anderson, Quinn & Stifel, Honolulu, Hawaii
  • Legislative Assistant, United States Representative Benjamin L. Cardin, Member of the House Ways and Means Committee's Health Subcommittee
Publications
Speaking Engagements
  • "Gainsharing Arrangements and Bundled Payments: OIG Advisory Opinion and Other Developments," Strafford Live Webinar (November 2019)
  • "20th Annual ABA Emerging Issues in Healthcare Law Conference" (March 2019)
  • Presenter – "Board Compliance Training–What's it All About," AHLA Fraud & Compliance Forum, Baltimore, Maryland (September 2018)
  • Co-presenter – "Gainsharing Arrangements and Bundled Payments: OIG Advisory Opinion and Other Developments," Strafford Webinar (May 2018)
  • Co-presenter – "Achieving Hospital-Physician Integration Through Effective Co-Management Arrangements," AHLA Physicians and Hospitals Law Institute, New Orleans, Louisiana (February 2018)
  • Co-presenter – "Healthcare Supply Chain Compliance: Minimizing Regulatory and Contractual Liability Risk," Strafford webinar (May 2017)
  • Panelist – "Structuring Gainsharing Arrangements and Bundled Payments," Strafford Webinar (March 2017)
  • Presenter – "How to Identify and Limit Regulatory Risks in Health Care Transactions," Evolution of a Health Care Deal, Ober|Kaler and BNA Bloomberg (2016)
  • Presenter – "What Every Seasoned Transactional Health Care Lawyer Should Know about Key Regulatory Elements of a Health Care Transaction, Part V: Common Regulatory Pitfalls in Acquisitions: the Stark Law, AKS and FCA," AHLA webinar (May 2016)
  • Co-presenter – "Gainsharing Arrangements and Bundled Payments: Latest Developments," Strafford webinar (December 2015)
  • Co-presenter – "Hot Compliance Risk Areas for DME Suppliers," Medtrade Conference (October 2015)
  • Co-presenter – "Gainsharing Arrangements," Strafford webinar (April 2014)
  • Co-presenter – "Deciphering the Self-Disclosure Puzzle," Emerging Issues in Healthcare Law program, American Bar Association's Health Law Section (February 2014)
  • Co-presenter – "Update from the OIG," D.C. Bar (December 2013)
  • Co-presenter – "Cutting Through the Buzz to Get to the Hot Risk Areas for DME Suppliers," Medtrade Conference, Atlanta, Georgia (October 2012)
  • Co-presenter – "Healthcare Fraud and Abuse Bootcamp Webinar Series, Part VI: Trends in Government Enforcement and Best Practices for Investigating and Defending Healthcare Fraud Actions," AHLA webinar (June 2012)
  • Co-presenter – "Legal & Investigational Issues with Short Stays," AHLA, Institute on Medicare and Medicaid Payment Issues, Baltimore, Maryland (March 2012)
  • Co-presenter – "Practical Side of Investigating And Reporting Overpayments," ABA Health Law Section, Emerging Issues in Healthcare Law Conference, San Diego, California (February 2012)

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