Brandon W. Shirley

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

• 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

• Co-Author, "Will Legislatures Put Telehealth on Hold in 2021?" Krieg DeVaulth Health Care Newsletter, January 2021
• Co-Author, "Don't Lose Focus on Your Compliance with Important COVID-19 Requirements," Krieg DeVault Health Care Newsletter, November 2020
• Co-Author, "Indiana Improves Telemedicine Reimbursement During COVID Emergency," Krieg DeVault Health Care Newsletter, October 2020
• Co-Author, "Check Before You Repay: CMS Contractors' Overpayment Extrapolation Methods Questioned," Krieg DeVault Health Care Newsletter, September 2020
• Co-Author, "Don't Be Surprised by Indiana's New Surprise Billing Requirements Effective July 1, 2020," Krieg DeVault Health Care Newsletter, July 2020
• Co-Author, "Protect Yourself from Anti-Kickback Statute Liability When Donating PPE," Krieg DeVault Health Care Newsletter, May 2020
• Co-Author, "CMS Publishes New Medicare Changes to Address the COVID-19 Pandemic," Krieg DeVault Health Care Newsletter, May 2020
• Co-Author, "CMS Announces Recommendations for Reopening Facilities to Provide Non-Emergent Health Care," Krieg DeVault Health Care Newsletter, April 2020
• Co-Author, "Governor Holcomb Issues Additional Licensure Waivers to Increase Health Providers Available to Address COVID-19," Krieg DeVault Health Care Newsletter, April 2020
• Co-Author, "Governor Holcomb Waives More Indiana Health Care Laws in Executive Order 20-13 to Address COVID-19," Krieg DeVault Health Care Newsletter, March 2020
• Co-Author, "CMS Expands and Makes Advance Medicare Payments More Available to Address Cash Flow Affected by COVID-19," Krieg DeVault Newsletter, March 2020
• Co-Author, "Indiana Medicaid Covers Telemedicine Services in COVID-19 Response," Krieg DeVault Health Care Newsletter, March 2020
• Co-Author, "OCR Temporarily Lessens HIPAA Requirements for Telecommunications in Wake of COVID-19," Krieg DeVault Health Care Newsletter, March 2020
• Co-Author, "CMS and OIG Temporarily Clear Regulatory Obstacles to Expand Telehealth Coverage to Address COVID-19," Krieg DeVault Health Care Newletter, March 2020
• Co-Author, "CMS Moves Closer to Clarifying Hospital Co-Location Rules with Draft Guidance", Krieg DeVault Health Care Newsletter (June 2019)
• Co-Author, "D.C. District Court Invalidates Medicaid Work Requirements", Krieg DeVault Health Care Newsletter (April 2019)
• Co-Author, "Indiana Medicaid Finalizes Rule Affecting ABA Therapy Services", Krieg DeVault Health Care Newsletter (March 2019)
• Co-Author, "How Does Your Organization's Medicare/Medicaid Overpayments Policy Compare", Krieg DeVault Health Care Newsletter (February 2019)
• Co-Author, "Updates to the Office of Inspector General Work Plan and Compliance Website", Krieg DeVault Health Care Newsletter (February 2019)
• Co-Author, "Are you ready for changes to Medicare Part D prescription requirements?", Krieg DeVault Health Care Newsletter (February 2019)
• Co-Author, "Indiana Proposes New Rule Impacting Pharmacy Reimbursement", Krieg DeVault Health Care Newsletter (January 2019)
• Co-Author, "Indiana Medicaid Rule Changes to Expect for 2019", Krieg DeVault Health Care Newsletter (January 2019)
• Co-Author, "Medicaid Presumptive Eligibility Moves to Fee-For-Service", Krieg DeVault Health Care Newsletter (December 2018)
• Co-Author, "US Department of Justice Announces Changes to Corporate Investigation Protocol", Krieg DeVault Health Care Newsletter (December 2018)
• Co-Author, "CMS Rule Reducing Medicare Payments for Certain Clinic Visits by Off-Campus PBDs", Krieg DeVault Health Care Newsletter (December 2018)
• Co-Author, "Indiana Medicaid publishes a proposed rule overhauling its Medicaid program integrity requirements", Krieg DeVault Health Care Newsletter (October 2018)
• Co-Author, "Trump Administration Makes Changes to Appointment of Federal Administrative Law Judges", Krieg DeVault Health Care Newsletter (September 2018)
• "US Department of Justice Issues Two Memoranda That Limit False Claims Act Litigation", Indiana Podiatric Medical Association Forward, 2018
• Co-Author, “HHS OIG Recommends Greater Efforts by Medicaid Managed Care Organizations in Identifying and Addressing Medicaid Fraud and Abuse”, Krieg DeVault Health Care Newsletter (August 2018)
• Co-Author, “The Joint Commission to Require Immediate Notification for Loss of Deemed Status”, Krieg DeVault Health Care Newsletter (June 2018)
• Co-Author, “Indiana Medicaid Proposes Overhaul of Program Integrity Rules”, Krieg DeVault Health Care Newsletter (June 2018)
• Co-Author, “Indiana Medicaid Finalizes Rule Changes Affecting Medicaid Home Health Providers”, Krieg DeVault Health Care Newsletter (May 2018)  
• Co-Author, “Bipartisan Budget Act Includes Important Changes to Fraud and Abuse Penalties”, Krieg DeVault Health Care Newsletter (May 2018)
• Co-Author, “CMS Revises the MLN Telehealth Services Booklet”, Krieg DeVault Health Care Newsletter (March 2018)
• Co-Author, “OIG Allows Retail Pharmacy's Discount Program to Include Medicaid and Medicare Beneficiaries”, Krieg DeVault Health Care Newsletter (October 2017)
• “United States Senate Narrowly Fails to Advance Health Care Reform Legislation”, Krieg DeVault Health Care Newsletter (July 2017)
• “HHS To Review Anti-Discrimination Rule That Applies Protections to Transgender Patients”, Krieg DeVault Health Care Newsletter (July 2017)
• Co-Author, “DOJ Releases Guidelines for Evaluating Effective Compliance Programs”, Krieg DeVault Health Care Newsletter (April 2017)
• "HHS OIG Publishes New Regulations that Expand its Authority to Exclude Health Care Providers from Participation in the Program", Krieg DeVault Health Care Newsletter (February 2017)
• "HHS OIG Adds New Authorities to the Anti-Kickback Statute and Civil Monetary Penalties Law", Krieg DeVault Health Care Newsletter (February 2017)
• "Federal judge temporarily enjoins rule prohibiting discrimination on the basis of gender identity", Krieg DeVault Health Care Newsletter (January 2017)

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

Practices

• Health Care Litigation
• Pharmacy and Pharmaceutical Law
• Long-Term Care Providers
• Health Care Reimbursement
• In-House Counsel Services
• Telehealth and Telemedicine
• Medicaid Strategy and Health Policy
• Hospitals and Health Systems

Industries

• Health Care