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Philip Peisch
Philip J. Peisch
Special Counsel
Washington +1 202 662 5225 Download V-card

Phil Peisch helps clients navigate complex issues and disputes arising out of government-sponsored health care programs. Mr. Peisch has particular expertise regarding Medicaid, the Children Health Insurance Program (CHIP), and the Affordable Care Act’s regulation of private insurance (ACA). He also counsels clients with respect to Medicare reimbursement; certification of and reimbursement issues relating to Electronic Health Records; state regulation of private health insurance; and other state and federal rules and policies governing the health care industry.

  • Represented health insurers in litigation with the federal government over the ACA’s risk corridors and risk adjustment programs.
  • Advised on and helped successfully negotiate a Section 1115 demonstration to expand a State’s Medicaid program to cover the Affordable Care Act’s new low-income adult group.
  • Counseled health insurers on compliance with the market reforms in Title I of the Affordable Care Act.
  • Successfully represented a state agency challenging a Medicaid disallowance related to the collection of alleged overpayments before the HHS Departmental Appeals Board.
  • Advised technology developer on compliance with Electronic Health Records certification requirements.
  • Represented a state agency responding to audits of home- and community-based services programs conducted by the HHS OIG.
  • Advised a state agency seeking an extension of a Section 1115 demonstration project to provide Medicaid coverage to an otherwise uncovered population.
  • Drafted comments for several state agencies on Medicaid Alternative Benefit Plan regulations proposed by CMS.
  • Defended a state agency in an Olmstead class action challenging the State’s Medicaid home- and community-based services program.
  • Successfully defended a state agency in an appeal before the Second Circuit arising out of a challenge to the State’s Medicaid rates.

Memberships and Affiliations

  • American Health Lawyers Association
  • Former Commissioner, DC Advisory Neighborhood Commission (2013-2014)
  • Former Co-Head Agent, Class of 2004, Dartmouth College Fund (2009-2014)

Previous Experience

  • Deputy Press Secretary, Office of Senator James M. Jeffords, I-Vt. (2005-2006)