Anil Shankar

Experience

Anil Shankar is a health care lawyer who provides strategic counsel to health care providers as they navigate complex regulatory and reimbursement matters, with a particular focus on the Medicaid program and issues affecting safety net providers. He is a partner in the firm’s Health Care & Life Sciences Sector.

Anil has been recognized by Chambers USA: America’s Leading Business Lawyers:

“Anil is brilliant. He has a knack for assimilating information and boiling complicated issues down to their essence. He exercises good judgment and has an intuitive understanding of our risk profile. He can also be creative.”

Medicaid Experience

Anil advises hospitals, clinics, health systems, other providers, managed care plans, and governmental entities on their participation in Medicaid programs. He has helped develop innovative new programs, including Medicaid supplemental payments, quality networks, state and local provider taxes or assessments, and public-private partnerships. He has extensive experience in the use of health care funding to address the social determinants of health and helped to design and implement California’s Whole Person Care pilots, which operate innovative programs for individuals experiencing homelessness, individuals leaving incarceration, individuals with significant mental health disorders, and other vulnerable populations.

He advises clients on numerous Medicaid reimbursement and compliance issues, including overpayment investigations and analyses. He has also assisted numerous companies seeking to enter the Medicaid program. Anil also has deep knowledge of Medicaid managed care and has helped plans and providers evaluate regulatory changes and structure alternative payment methodologies to meet their goals.

Anil has also successfully obtained millions of dollars of Medicaid funding providers and mental health delivery systems through successful challenges to program audits and disallowances.

340B Drug Pricing Program

Anil heads the firm’s robust 340B Drug Pricing Program practice, which counsels hospital systems, federally qualified health centers, and federal grantees with regard to their obligations and opportunities under the program. He advises clients on compliance and overpayment issues, self-disclosures, internal and governmental audits, 340B contracting, and has helped to restructure entities to maximize 340B Program savings.

Behavioral Health

Anil has extensive experience advising clients on behavioral health reimbursement, operational, and compliance issues. He has counseled hospitals on health systems seeking to expand their behavioral health offerings, including strategic counseling to avoid licensing, regulatory, and reimbursement pitfalls. In addition, Anil has helped design systems to protect and share confidential patient information, including behavioral health information. He works with local behavioral health directors, providers, and managed delivery systems on issues related to funding, reimbursement, program development, and strategic implementation.

Federal Relief and Grant Funds

During the coronavirus pandemic, Anil advised hospitals, health systems, governmental entities, nursing facilities, and other health care companies regarding their application, receipt, and use of federal relief funds, including the Provider Relief Fund and Coronavirus Relief Fund. He helped clients develop tracking and documentation systems, counseled providers regarding both over- and under-payments of funds, and drafted policies and procedures for use and reporting of funds. He advises recipients of grant funds on federal audits.