Andrew Ruskin counsels hospitals, pharmaceutical and medical device companies, and Medicare Advantage plans, among others, on a range of Medicare and Medicaid regulatory, litigation, and transactional matters. Andy advises on strategic issues surrounding coverage, reimbursement, and compliance, as well as drug pricing and price reporting. He defends clients in investigations by the US Attorney’s Office and the Department of Health and Human Services Office of Inspector General, and he appears before several regulatory tribunals, such as the Provider Reimbursement Review Board and the HCPCS Committee.
Healthcare services providers and payors seek Andy’s advice and strategic planning regarding a wide range of Medicare and Medicaid reimbursement and compliance issues including graduate medical education reimbursement; clinical trial reimbursement; drug and device coverage and reimbursement; provider-based status; 340B, ASP, and Medicaid Drug Rebate Program compliance; maximizing reimbursement through optimal organizational structuring; minimizing False Claims Act exposure; and federal fraud and abuse laws.
Andy helps solve complex operational issues clients face as a result of challenges in the regulatory regime, and he helps clients advocate for regulatory changes before the Centers for Medicare and Medicaid Services. He also drafts operational agreements, such as affiliation agreements, joint venture agreements, rebate agreements, and distribution agreements.
Andy lectures frequently on reimbursement methodologies, compliance, and fraud and abuse before the American Health Lawyers Association, the Health Care Compliance Association, the Healthcare Financial Management Association, and the Annual National Congress on Health Care Compliance.
Case Western Reserve University School of Law, 1996, J.D., Magna Cum Laude
Wesleyan University, 1987, B.A.
District of Columbia
Awards and Affiliations
Named, Modern Healthcare’s “Largest Healthcare Firm” (2016–2019)
Life Sciences Star Regulatory, LMG Life Sciences (2018, 2019)
Life Sciences Star, Non-IP Litigation and Enforcement, LMG Life Sciences (2016–2017)
Life Sciences Star, Pricing and Reimbursement, LMG Life Sciences (2012–2015)
Recommended, The Legal 500 US (2016)
Chair, Planning Committee for American Health Lawyers Association’s (AHLA) 2018 Institute on Medicare and Medicaid Payment Issues
Former Chair, American Health Lawyers Association, Regulatory, Accreditation & Payment Practice Group
Member, Editorial Advisory Board, Report on Medicare Compliance