|
Caroline Brown's practice focuses on government-sponsored health care programs -- including Medicaid, Medicare, CHIP, and the Affordable Care Act -- with a special emphasis on how the different programs interrelate. Resident in our Washington office, Ms. Brown is co-chair of the firm’s Health Care Industry Group, and chair of the Federal-State Programs practice.
Ms. Brown helps her clients navigate and comply with regulatory and statutory provisions that courts have described as “among the most completely impenetrable texts within human experience.” With over 20 years’ experience in the field, the key to Ms. Brown’s success is understanding how those provisions are interpreted and applied by the Centers for Medicare & Medicaid Services (CMS) through subregulatory guidance and uncodified policies and procedures. In light of that experience, Ms. Brown is regularly called upon to counsel clients regarding Section 1115 demonstration projects, Medicaid upper payment limits (UPL), Medicare and Medicaid disproportionate share hospital (DSH) payments, certified public expenditures (CPE), graduate medical education (GME), Medicaid managed care, payment for home and community-based services, dual eligibles, and provider taxes, among other issues that arise in these complex government programs.
Ms. Brown also frequently litigates issues related to government health care programs in federal court and in administrative appeals within the U.S. Department of Health and Human Services before the Departmental Appeals Board (DAB) and the Provider Reimbursement Review Board (PRRB). She is a member of the U.S. District Courts for the District of Columbia, the Western District of Michigan, and the Eastern, Southern, and Western Districts of New York; as well as the U.S. Court of Appeals for the First, Second, Third, Fifth, Seventh, Eighth, Ninth, Eleventh, D.C. and Federal Circuits, and the U.S. Supreme Court.
Representative Matters
- Successfully challenged CMS’s interpretation of Medicare DSH rules as applied to dual eligibles.
- Successfully challenged CMS’s interpretation of the “free care” rule as applied to school-based health services.
- Secured reversal of a CMS Medicaid state plan disapproval involving reimbursement for hospital-based rural health clinics.
- Obtained increased Medicare GME payments for teaching hospital before the PRRB and in district court.
- Successfully represented state health care program in appeal involving over $100 million in Medicaid payments to federally qualified health centers.
Honors and Rankings
- Washington, D.C. Super Lawyers, Health Care
Pro Bono
- Counsel to the National Law Center on Homelessness and Poverty in litigation against the federal government concerning compliance with Title V of the McKinney-Vento Homeless Assistance Act.
- Filed Supreme Court amicus brief on behalf of the National Partnership for Women & Families and others in Jackson v. Birmingham Bd. of Education.
Publications and Speeches
- Ms. Brown is a frequent speaker at health care conferences on issues related to Medicaid and the Affordable Care Act.
- “Q&A With Covington's Caroline Brown,” Law360 (5/29/2012)
|