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Brandon W. Shirley has a diverse knowledge of Federal and State regulations. He has extensive experience with State and Federal Medicaid laws, regulations, policies, waiver programs, audits, and administrative appeals having previously served in top-level legal positions with the State of Indiana. His practice extends to Medicaid managed care policies, audits, and disputes. He assists clients investigating and appealing government overpayment determinations or other Medicare or Medicaid sanctions. He assists clients with internal investigations of noncompliance issues involving Medicare and Medicaid billing. He has additional experience with Medicare and Medicaid pharmacy issues, including 340B drug pricing, telehealth and telemedicine, State and Federal site surveys, Department of Health and licensure issues, and Federally Qualified Health Centers.

Mr. Shirley specializes in Medicare and Medicaid fraud and abuse laws, including establishing arrangements that comply with the Anti-Kickback Statute and Stark Law. He has assisted clients facing qui-tam lawsuits, government sanctions, or with government investigations or self-reporting noncompliance. He has extensive experience assisting clients with implementing policies for and complying with Corporate Integrity Agreements.

Seminars & Presentations

  • Presenter, "Office of Inspector General (OIG) Compliance Guidance," Indiana Rural Health Association Spring Summit, March 5, 2024
  • Co-Presenter, “End of the Public Health Emergency: A Federal and State Regulatory Overview for Physicians,” Indiana State Medical Association, May 25, 2023
  • Co-Presenter, "Understanding Regulations to Guide Effective Strategy," Indiana Rural Health Association Spring Rural Summit, April 11, 2023
  • Presenter, "2023 Congressional Outlook," Healthcare Financial Management Association, February 16, 2023
  • Presenter, "Medicare Overpayment Proposed Rule," Indiana Statewide Rural Hospital Network CFO Roundtable, February 9, 2023
  • Presenter, "CMS's Proposed Government Overpayment Rule Is Sure to Make You Sleep Less," Krieg DeVault Podcast Series, February 8, 2023
  • Co-Presenter, "Indiana Abortion Law Post Dobbs and Senate Enrolled Act 1 - What Physicians Need to Know," Indiana State Medical Association, September 14, 2022
  • Presenter, "Indiana Licensing Q&A," American Massage Therapy Association ," September 12, 2022
  • Co-Presenter, "New Options: Rural Emergency Hospitals and Critical Access Hospitals," Indiana Rural Health Association," September 8, 2022
  • Presenter, "No Surprises Act," Meritas Law Firms Worldwide Health Care Practice Group, August 11, 2022
  • Co-Presenter, "Take the Surprise Out of Surprise Billing Laws - Part 3/Dispute Processes and Procedures,"  Indiana Medical Group Management Association, July 20, 2022
  • Co-Presenter, "Take the Surprise Out of Surprise Billing Laws - Part 2/Good Faith Estimates," Indiana Medical Group Management Association, June 8, 2022
  • Co-Presenter, "Take the Surprise Out of Surprise Billing Laws - Part 1/Surprise/Balance Billing," Indiana Medical Group Management Association, June 2, 2022
  • Presenter, "Key Considerations for Pharmacy Compliance: An Overview of Recent State and Federal Cases," Indiana Pharmacists Association, March 4, 2022 
  • Presenter, "Surprise Billing: Patient Protection Etched into Law Webinar, Indiana State Medical Association," December 17, 2021
  • Presenter, "Into the Unknown: A look Into the Uncertain Future of New Surprise Billing Laws," Krieg DeVault Podcast Series, August 21, 2021
  • Co-Presenter, "Take the Surprise Out of Surprise Billing Laws," Indiana Medical Group Management Association, 2021
  • Co-Presenter, "No Surprises - Understanding and Complying with New Medical Price Transparency Laws," IndyBar Association, 2021
  • Co-Presenter, "Indiana Surprise Medical Billing: What You Need to Know About HB 1004," Indiana Primary Health care Association, 2020
  • Co-Presenter, "Don't Be Surprised By Surprise Billing: What You Need to Know About HB 1004," Krieg DeVault, 2020
  • Co-Presenter, Telemedicine: The New Frontier During COVID-19, Indiana State Medical Association 2020
  • Medicare and Medicaid Overpayments, Indiana Medical Group Management Association, Webinar, 2019
  • Corporate Compliance: Best Practices, Indiana Osteopathic Association's 3rd Annual Summer Update, 2019
  • Medical Documentation for Government Audits, Eskenazi Health, 2019
  • Medicaid and Medicare Overpayments, Eskenazi Health, 2019
  • Health Care Case Law Update, Indianapolis Bar Association, March 2019

Publications

Education

  • J.D., Dean's List, Indiana University Robert H. McKinney School of Law, Indianapolis, Indiana, 2010
    • Vice President, J. Ruben Clark Law Society
    • Participant, Trial Practice Course
    • Participant Staton Intramural Moot Court Competition
  • B.A. in English, magna cum laude, University of Utah, Salt Lake City, Utah, 2007

Bar & Court Admissions

  • Indiana (2010)
  • U.S. District Court for the Northern District of Indiana
  • U.S. District Court Southern District of Indiana
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Marathons

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Painting

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History

Thought Leadership

Upcoming INSPECT Compliance Dates

October 28, 2018

Thought Leadership

Lights, Camera, Sanction

October 25, 2018

Thought Leadership

Dismissal of Non-Intervened Qui Tam Lawsuits

February 1, 2018

Thought Leadership

Recent DOJ Settlements with Physician Groups

February 1, 2018

Thought Leadership

HIPAA Security...Integrity Matters

February 1, 2018

Thought Leadership

CMS Issues Guidance Regarding Texting Physician Orders

January 9, 2018

Thought Leadership

Judge Allows Reduced 340B Payments, Effective 1/1/2018

January 3, 2018

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Brandon W. Shirley has a diverse knowledge of Federal and State regulations. He has extensive experience with State and Federal Medicaid laws, regulations, policies, waiver programs, audits, and administrative appeals having previously served in top-level legal positions with the State of Indiana. His practice extends to Medicaid managed care policies, audits, and disputes. He assists clients investigating and appealing government overpayment determinations or other Medicare or Medicaid sanctions. He assists clients with internal investigations of noncompliance issues involving Medicare and Medicaid billing. He has additional experience with Medicare and Medicaid pharmacy issues, including 340B drug pricing, telehealth and telemedicine, State and Federal site surveys, Department of Health and licensure issues, and Federally Qualified Health Centers.

Mr. Shirley specializes in Medicare and Medicaid fraud and abuse laws, including establishing arrangements that comply with the Anti-Kickback Statute and Stark Law. He has assisted clients facing qui-tam lawsuits, government sanctions, or with government investigations or self-reporting noncompliance. He has extensive experience assisting clients with implementing policies for and complying with Corporate Integrity Agreements.

Seminars & Presentations

  • Presenter, "Office of Inspector General (OIG) Compliance Guidance," Indiana Rural Health Association Spring Summit, March 5, 2024
  • Co-Presenter, “End of the Public Health Emergency: A Federal and State Regulatory Overview for Physicians,” Indiana State Medical Association, May 25, 2023
  • Co-Presenter, "Understanding Regulations to Guide Effective Strategy," Indiana Rural Health Association Spring Rural Summit, April 11, 2023
  • Presenter, "2023 Congressional Outlook," Healthcare Financial Management Association, February 16, 2023
  • Presenter, "Medicare Overpayment Proposed Rule," Indiana Statewide Rural Hospital Network CFO Roundtable, February 9, 2023
  • Presenter, "CMS's Proposed Government Overpayment Rule Is Sure to Make You Sleep Less," Krieg DeVault Podcast Series, February 8, 2023
  • Co-Presenter, "Indiana Abortion Law Post Dobbs and Senate Enrolled Act 1 - What Physicians Need to Know," Indiana State Medical Association, September 14, 2022
  • Presenter, "Indiana Licensing Q&A," American Massage Therapy Association ," September 12, 2022
  • Co-Presenter, "New Options: Rural Emergency Hospitals and Critical Access Hospitals," Indiana Rural Health Association," September 8, 2022
  • Presenter, "No Surprises Act," Meritas Law Firms Worldwide Health Care Practice Group, August 11, 2022
  • Co-Presenter, "Take the Surprise Out of Surprise Billing Laws - Part 3/Dispute Processes and Procedures,"  Indiana Medical Group Management Association, July 20, 2022
  • Co-Presenter, "Take the Surprise Out of Surprise Billing Laws - Part 2/Good Faith Estimates," Indiana Medical Group Management Association, June 8, 2022
  • Co-Presenter, "Take the Surprise Out of Surprise Billing Laws - Part 1/Surprise/Balance Billing," Indiana Medical Group Management Association, June 2, 2022
  • Presenter, "Key Considerations for Pharmacy Compliance: An Overview of Recent State and Federal Cases," Indiana Pharmacists Association, March 4, 2022 
  • Presenter, "Surprise Billing: Patient Protection Etched into Law Webinar, Indiana State Medical Association," December 17, 2021
  • Presenter, "Into the Unknown: A look Into the Uncertain Future of New Surprise Billing Laws," Krieg DeVault Podcast Series, August 21, 2021
  • Co-Presenter, "Take the Surprise Out of Surprise Billing Laws," Indiana Medical Group Management Association, 2021
  • Co-Presenter, "No Surprises - Understanding and Complying with New Medical Price Transparency Laws," IndyBar Association, 2021
  • Co-Presenter, "Indiana Surprise Medical Billing: What You Need to Know About HB 1004," Indiana Primary Health care Association, 2020
  • Co-Presenter, "Don't Be Surprised By Surprise Billing: What You Need to Know About HB 1004," Krieg DeVault, 2020
  • Co-Presenter, Telemedicine: The New Frontier During COVID-19, Indiana State Medical Association 2020
  • Medicare and Medicaid Overpayments, Indiana Medical Group Management Association, Webinar, 2019
  • Corporate Compliance: Best Practices, Indiana Osteopathic Association's 3rd Annual Summer Update, 2019
  • Medical Documentation for Government Audits, Eskenazi Health, 2019
  • Medicaid and Medicare Overpayments, Eskenazi Health, 2019
  • Health Care Case Law Update, Indianapolis Bar Association, March 2019

Publications

Education

  • J.D., Dean's List, Indiana University Robert H. McKinney School of Law, Indianapolis, Indiana, 2010
    • Vice President, J. Ruben Clark Law Society
    • Participant, Trial Practice Course
    • Participant Staton Intramural Moot Court Competition
  • B.A. in English, magna cum laude, University of Utah, Salt Lake City, Utah, 2007

Bar & Court Admissions

  • Indiana (2010)
  • U.S. District Court for the Northern District of Indiana
  • U.S. District Court Southern District of Indiana

Insights

Thought Leadership

Upcoming INSPECT Compliance Dates

October 28, 2018

Thought Leadership

Lights, Camera, Sanction

October 25, 2018

Thought Leadership

Dismissal of Non-Intervened Qui Tam Lawsuits

February 1, 2018

Thought Leadership

Recent DOJ Settlements with Physician Groups

February 1, 2018

Thought Leadership

HIPAA Security...Integrity Matters

February 1, 2018

Thought Leadership

CMS Issues Guidance Regarding Texting Physician Orders

January 9, 2018

Thought Leadership

Judge Allows Reduced 340B Payments, Effective 1/1/2018

January 3, 2018

See LessSee All