Ross Burris benefits clients by applying a strong business acumen to understanding the goals and challenges clients face, and by leveraging a commanding ability to counsel on intricate legal matters. His experience includes advising clients regarding the complex and ever-changing federal and state regulatory environment. Ross approaches each issue with a practical application that is unique to the client’s context, and draws on a strong background of working with numerous regional and national health care providers, including:
  • Hospitals
  • Health systems
  • Long term care providers 
  • Durable medical equipment suppliers
  • Independent laboratories
Clients value Ross’s meticulous attention to detail when counseling on their business interactions which include:
  • Medicare and Medicaid reimbursement audits, disputes and appeals
  • Commercial Payor disputes and resolutions in mediation and arbitration
  • Billing and coding audits by government and commercial payors  
  • Government investigations, including False Claims Act Litigation 
  • State and Federal regulatory compliance
  • Health care compliance 
Ross’s compliance work encompasses numerous federal and state health law requirements, including Medicare Reimbursement Audits, Medicaid issues and Commercial Payor disputes and Medicare billing guidelines. Ross is a former prosecutor and actively involved in the Atlanta community as a member of the Advisory Council for the Health Law Partnership (HeLP) and an Executive Committee Member for the Young Professionals Council of the Georgia Appleseed Center for Law and Justice. He is a frequent speaker and author for the American Health Law Association (AHLA), Health Care Compliance Association (HCCA), and the Georgia Hospital Association (GHA). Ross has been recognized several times by Super Lawyers in the area of Health Care. 
  • Representation of regional and national health care providers, including hospitals, health care systems, skilled nursing facilities and ancillary providers, in a range of matters related to Medicare reimbursement disputes before Medicare administrative contractors, state Medicaid agencies and the centers for Medicare and Medicaid Services (CMS) including billing and coding audits, government investigations, and other compliance matters
  • Representation of health care providers at all stages of False Claims Act litigation, OIG/DOJ investigations, commercial disputes between health care providers, defense of audits, civil fraud investigations and appeals before state and federal administrative bodies
  • Representation of hospitals and health systems in operational issues related to state licenses and permits, Medicare and Medicaid enrollment, accreditations, hospital and physician integration, professional services arrangements, physician recruitment, call coverage arrangements, HIPAA privacy matters, EMTALA, peer review and case management
  • Representation of hospital authorities and health systems in issues related to regulatory approval for the sale and transfer of hospitals
  • Served as outside litigation counsel for several Georgia health systems, and in that capacity conducted numerous internal investigations related to physician services, protected health information disclosures and overpayments
  • Brought multiple actions on behalf of hospitals in arbitration and litigation against Medicaid managed care organizations related to underpayments and improper rate changes 
  • Conducted internal review for large health system related to improper billing and negotiated refund
  • Defended three separate FCA actions related to a hospice company with locations in Wisconsin, Mississippi and Alabama
  • Defended FCA action related to independent diagnostic testing facilities where the government intervened in Tennessee
  • Defended government investigation and subsequent FCA action for LTACH related length of stay in Texas; negotiated final settlement with DOJ and Relator’s counsel
  • Defended government investigation and subsequent FCA action related to DME company in Georgia
  • Defended two separate government investigations related to national emergency medicine group
  • Defended hospital investigation from state Medicaid fraud control unit
  • Defended national ambulance company in multiple false claims actions in New York, Florida and Arizona 
  • Defended RAC audits and subsequent appeals for multiple regional health systems
  • Defended ZPIC and UPIC audits and subsequent appeals for physician groups, durable medical equipment suppliers, lab companies and hospice providers 
  • Defended ZPIC audit and subsequent appeals through reconsideration for national sleep and home oxygen company with a $15 million extrapolated demand; successfully overturned extrapolation at reconsideration level
  • Defended ZPIC audit and subsequent appeals through reconsideration for DME with $2 million extrapolated demand; successfully overturned extrapolation at reconsideration level
  • Defended commercial payor audit and subsequent appeals with extrapolated demand; successfully negotiated overturning extrapolation
  • Defended emergency medicine group on 100 percent pre-payment review and audits; successfully negotiated removal from review and overturned audits
  • Defended emergency medicine group’s medical review audits; successfully overturned 100 percent of determinations at ALJ
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