About Alessandra Denis

Health care providers rely on Alessandra Denis to guide them on the regulatory issues and concerns that can hinder their operations if not handled properly. From representing providers in negotiating agreements to investigating and litigating FCA matters, Alessandra offers deep knowledge of the health care industry and regulatory environment.

360-degree regulatory advice for health care providers

Alessandra also advises health care providers regarding compliance with state and federal health care laws, including Medicare and Medicaid reimbursement, fraud and abuse, anti-kickback, physician self-referral, Medicare and Medicaid exclusion laws and the investigation and disclosure of overpayments. She has also represented employers in matters arising under federal, state and local employment laws.

Practice Focus

  • Health care litigation
  • False Claims Act investigations and litigation
  • Negotiating affiliation agreements and managed care participating provider agreements
  • Medicare and Medicaid reimbursements and Section 1115 Medicaid demonstration programs
  • Compliance

Representative Experience

  • Represented public school district in obtaining dismissal of a qui tam False Claims Act complaint alleging submission of false Medicaid claims for health care services to disabled students, and in an appeal in the Second Circuit.
  • Represent large health care system seeking judicial review of a decision by the Secretary of the US Department of Health and Human Services concerning the denial of reimbursement of costs for ancillary services.
  • Represent large health care system in negotiating affiliation agreements with medical schools and physician groups.
  • Represent large health care system before the Provider Reimbursement Review Board involving Medicare cost reporting issues. 
  • Conduct internal investigations into potential liability of health care provider under the False Claims Act, the Civil Monetary Penalties Law and state law.
  • Represent large health care system in negotiations with managed care organizations regarding participating provider agreements for Medicare, Medicaid and New York State marketplace products.  
  • Represent large health care system in negotiations with Medicaid managed care organizations participating in program to transition hospitals to value-based purchasing models.
  • Advise health care provider and Medicaid managed care organization on reporting and payment or recoupment of overpayments to network and out-of-network providers. 
  • Advise health care provider on federal regulatory changes in Medicaid supplemental and state-directed managed care payments.
  • Advise large health care system on Medicare, Medicaid and regulatory compliance requirements for inpatient, outpatient and home health services.