Stephen Bittinger represents health care providers and businesses when reimbursement disputes turn on statistical sampling, extrapolated overpayment demands, AI or algorithmic systems and data-driven audit findings. He is a shareholder and co-chair of the APA Practice Group, with a practice focused on federal Administrative Procedure Act litigation, reimbursement litigation, audit and integrity matters, payor disputes and False Claims Act defense.

Stephen regularly handles disputes involving the use of statistics, data analytics, generative artificial intelligence and algorithmic systems as evidence or as the basis for liability in the health care reimbursement process. He represents clients in commercial payor disputes, government payor fraud investigations, waste and abuse audits, FCA proceedings, health care criminal proceedings and reimbursement-related litigation involving CMS, HHS-OIG, DOJ, VA, state Attorneys General and Medicaid Fraud Control Units.

Stephen has represented providers, suppliers, laboratories, pharmacies, revenue cycle management companies, health care technology vendors, drug and device manufacturers and investment companies on the care delivery side of the U.S. health care system and internationally. His work includes defending CMS audits, UPIC, RAC and TPE audits, Medicaid audits, private payor audits, payor appeals, network and enrollment termination proceedings, OIG exclusion and CMS preclusion appeals, and disputes involving statistical sampling and extrapolation.

Stephen has served as subject matter counsel and as an expert witness in disputes involving statistical sampling, AI-as-evidence, Medicare Part C reimbursement, Medicaid regulations, reimbursement methodology, CMS regulations and rural hospital compliance. He has been recognized by Chambers USA for Healthcare in South Carolina, selected for inclusion in Best Lawyers in America for Health Care Law and named a Legal Innovator Finalist by the Southeastern Legal Awards.

Education

  • University of Akron School of Law (J.D.)
    • John Carroll University (M.A.)
      • Kent State University (B.S.)

        Bar Admission

        • South Carolina
        • North Carolina
        • Ohio
        • District of Columbia

        Court Admissions

        • U.S. Court of Appeals, Fourth Circuit
        • U.S. Court of Appeals, Sixth Circuit
        • U.S. Court of Appeals, Ninth Circuit
        • U.S. Court of Appeals, Eleventh Circuit
        • U.S. Court of Federal Claims
        • U.S. District Court, District of Columbia
        • U.S. District Court, District of South Carolina
        • U.S. District Court, Northern District of Ohio
        • U.S. District Court, Southern District of Ohio
        • Supreme Court of the United States

        Recognition

        • Ranked in Chambers USA: America’s Leading Lawyers for Business, Healthcare, South Carolina, 2025-2026
        • Selected for inclusion in Best Lawyers in America® for Health Care Law, 2024-2026
        • Southeastern Legal Awards, Legal Innovator Finalist, 2024
        • Named “Presenter of the Year” by 1st Healthcare Compliance
        • Charleston Business Magazine’s Legal Elite, Health Care, 2022-2023
        Publications
        A ‘WISeR’ Move? House Panel Aims to Halt Funding for AI Prior Authorization Model
        Stephen Bittinger discusses congressional efforts to halt funding for CMS’s AI-driven Wasteful and Inappropriate Service Reduction (WISeR) model, a prior authorization program currently operating in six states. He raises concerns about the program’s reliance on opaque AI decision-making, arguing that providers lack visibility into the technology’s methodology and that the model may create significant due process, compliance and patient access issues. Bittinger notes that while a House committee has moved to block future funding for WISeR, the program remains active for now and healthcare providers should continue documenting denials, appeals and operational impacts as scrutiny of the model intensifies.
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        House Panel Moves to Block CMS’s AI-Driven Prior Authorization Program: What the WISeR Rider Could Mean for Providers
        Key Takeaways The House Appropriations Committee approved a rider June 9 that would block FY 2027 funding for CMS’s WISeR model. Unless the rider becomes law, however, the AI-driven prior authorization program will remain active in the six states where it currently operates. The rider could halt WISeR for FY 2027, but several legislative paths remain in play. Senate negotiations, a conference agreement or a continuing resolution could allow the program to continue, meaning providers should assume WISeR requirements remain in effect for now. Providers should continue documenting WISeR non-affirmations, appeals, outcomes and operational burdens. Those records may prove valuable for compliance efforts, litigation strategy and legislative advocacy as scrutiny of the program continues. On June 9, 2026, the House Appropriations Committee approved a
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