Anil Shankar

Practice Areas

Corporate, Health Care

Career

Anil Shankar is a partner and health care lawyer with Foley & Lardner LLP, and a member of the firm’s Health Care Practice. He 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.

Anil is a lecturer at the UCLA School of Law, where he teaches Health Care Compliance.

Medicaid Experience

Anil is a leading expert on the intricacies of the Medicaid program and routinely advises hospitals, clinics, health systems, trade associations, managed care plans, and governmental entities on their participation in Medicaid programs. He regularly counsels clients on the impact of state and federal policy changes and helps identify and design programs to succeed in a challenging regulatory or reimbursement environment, including demonstration projects, quality networks, state and local provider taxes, alternate payment models, and public-private partnerships. He counsels clients on specialized Medicaid payments including disproportionate share hospital (DSH) funding, state-directed payments, upper payment limit reimbursement, and other supplemental funding. He has extensive experience in the use of health care funding to address the social determinants of health, and has helped clients obtain Medicaid funding 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 assisted several companies seeking to enter the Medicaid program and has defended providers facing termination or other sanctions from state Medicaid agencies.

340B Drug Pricing Program

Anil has counseled hospitals, clinics, and grantees on their participation in the 340B Drug Pricing Program for more than 15 years. He advises clients on compliance and program design , 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.

Audits and Appeals

Anil advises health care providers and companies to track and oversee federal grants and reimbursement, including hemophilia treatment center funds, Ryan White funds, 340B funds, FQHCs, and has advised them during related audits. He has recovered millions of dollars by successfully challenging Medicaid reimbursement audit findings.

Professional Memberships

Faculty lecturer at the UCLA School of Law

Member, American Health Lawyer’s Association

Member, Los Angeles County Bar Association (Health Law Section)

Member, American Bar Association (Health Law Section)

Education

Work Highlights

Advised multiple California counties on legal considerations and strategies for structuring local indigent care programs to support individuals adversely impacted by implementation of Medicaid cuts.

Counseled health system on legal obligations and response to 340B program data requests.

Conducted privileged investigations of multiple billing and compliance issues, including Medicare and Medicaid reimbursement and FQHC billing.

Successfully appealed and settled a behavioral health provider’s termination from a state Medicaid program, resulting in their reinstatement.

Reviewed managed care contracts and drafted subcontractor and billing agreements for entities entering the Medicaid program.