Ryan Morgan understands that success in today's complex and competitive health care marketplace requires innovative ideas powered by intelligent legal guidance. Ryan's experience on both the provider and payor sides provides him a unique, big-picture perspective to offer tailored and creative legal advice for clients’ business challenges. Ryan previously served as in-house counsel for a large, non-profit health system and for a pharmaceutical benefit management organization with significant insurer operations. He has broad experience successfully advising on a variety of health care transactional, regulatory, and reimbursement issues, including:
  • Commercial and governmental managed care contracting 
  • Medicare Parts C and D compliance
  • Provider-Payor disputes and appeals
  • Stark, Anti-Kickback and other fraud, waste and abuse compliance
  • Hospital physician alignment, including formation and operation of clinically integrated networks
  • EMTALA and Medicare Condition of Participation compliance and defense, including QIO hearings
  • Led successful negotiation of a managed care arrangement between a large, multi-hospital health system and an insurer, valued at over $3 billion.
  • Represented a specialty pharmacy as it appealed its termination from an insurer’s provider network, resulting in its reinstatement.
  • Defended hospital in hearing before a Quality Improvement Organization resulting in CMS withdrawing its allegation that the hospital violated EMTALA and should be sanctioned.
  • Counseled a newly formed ACO on its structure, arrangements with providers, and value-based agreements with commercial insurers.
 
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