Brian McGovern is a partner at Crowell & Moring’s New York office.
Brian provides legal counsel and representation to health care and nonprofit clients. His experience spans the breadth of legal issues that confront the provider community, including counseling health care providers and managed care plans on regulatory compliance; responding to government audits and investigations, including Medicare contractor audits and New York State Office of Medicaid Inspector General (OMIG) and Attorney General Medicaid Fraud Control Unit (MFCU) inquiries; overseeing or performing internal compliance investigations; advising on and negotiating managed care, vendor, and other contracts; providing counsel and advocacy on reimbursement issues; assisting providers on administrative applications and matters before regulatory agencies, including rate appeals, certificate of need applications, and property tax exemption applications and appeals; responding to patient-care survey deficiency citations; and representing providers in administrative proceedings and litigation in state and federal courts. The providers he has represented include nursing homes, home care agencies, hospices, hospitals, continuing care retirement communities, pediatric facilities, and managed care plans.
Brian has also counseled provider associations on statutory, regulatory, and other legal developments impacting long-term care providers in New York State. Brian has given lectures and presentations to the health care industry on topics ranging from corporate compliance, False Claims Act, fraud and abuse investigations and prosecutions, OMIG and MFCU audit initiatives, managed care contracting, and real property tax exemption.
Brian is recognized as a leading health care lawyer by Chambers USA and is also recognized by The Best Lawyers in America, which named him "Lawyer of the Year" for Health Care Law in New York.
Brian served for five and a half years as an assistant attorney general for New York State, where he defended the state in, among other matters, Medicaid reimbursement litigation and other legal challenges to statutes, regulations, and agency actions affecting health care providers.
Representative Matters
- Conducted internal investigation on behalf of a hospice agency, and reported our findings and recommendations, into whistleblower allegations of improper placement of hospice patients for general inpatient services as well as alleged “bullying” and other misconduct by the agency’s senior executive staff.
- Conducted review of major pharmaceutical company’s compliance program on behalf of the company’s audit committee, required to certify program effectiveness pursuant to Office of Inspector General Corporate Integrity Agreement; and prepared two separate written reports to the committee concerning salient findings relating to sales and manufacturing respectively.
- Guided two managed long term care plans in performing internal investigations into enrollment of allegedly ineligible plan members and in preparing and submitting self-disclosures to the Medicaid Inspector General.
Brian graduated from Georgetown University Law Center. He is admitted to practice in New York State, the U.S. District Courts for the Southern and Eastern Districts of New York, and the U.S. Court of Appeals for the Second Circuit.
Affiliations
Admitted to practice: New York; U.S. District Court for the Southern District of New York, U.S. District Court for the Eastern District of New York, U.S. Court of Appeals for the Second Circuit, and U.S. Court of Appeals for the Fourth Circuit
Professional Activities and Memberships
- Chair, Health Law Committee, Association of the Bar of the City of New York
- Member, American Health Lawyers Association
- Member, Health Care Compliance Association
- Member, New York State Bar Association, Health Law Section
Speeches & Presentations
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"Medicaid Managed Care Organizations and the Social Determinants of Health," Healthcare Ounce of Prevention Seminar (HOOPS) 2021: Health Care in the Biden Era
(February 25, 2021).
Presenters: Gary Baldwin, Brian McGovern, and Megan Beaver.
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"COVID-19 Health Care Funding, Regulatory Waivers, and the False Claims Act: Protecting Your Business Today from Agency Enforcement and Whistle Blower Actions Tomorrow," Crowell & Moring Webinar
(April 30, 2020).
Presenters: Jacinta Alves, Mana Elihu Lombardo, Brian McGovern, Brian Tully McLaughlin, and David W. O'Brien
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"Ethics, Compliance, and Changing Federal Payment Paradigms," CCLC Long Term Care Compliance Forum
(September 24, 2019).
Presenter: Brian McGovern.
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"Health Care Fraud and Abuse Laws: What In-house Counsel Need to Know and How to Respond to an Investigation," ACC and Crowell & Moring Seminar, New York, NY
(June 27, 2019).
Speakers: Brian McGovern, Troy A. Barsky, Rebecca Monck Ricigliano, and John E. Davis.
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"Navigating Enforcement Activity Regarding Wage Parity Act Compliance in the Home Health Industry," Crowell & Moring Breakfast Seminar, New York, NY
(June 20, 2019).
Presenters: Kelly T. Currie, Brian McGovern, Rebecca Monck Ricigliano, and Eric Su.
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"Digital Health as Disrupter," ACC-NYC, New York, NY
(March 14, 2019).
Panelists: Brian McGovern, Jodi G. Daniel, and Alexis J. Gilman.
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"Regulatory and Compliance Issues for Home Care Agencies and Hospice Providers Participating in Managed Long Term Care Plans," HCA NYS Corporate Compliance Symposium, Albany, NY
(October 17, 2018).
Presenter: Brian McGovern.
Publications
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"HHS Approves Telecommunications for Providing Medicare Home Health Services, on a Permanent Basis, Effective January 1, 2021," Crowell & Moring’s Health Law Blog
(November 9, 2020).
Authors: Brian McGovern and Lidia Niecko-Najjum.
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"New York State Department of Health Seeks Additional 1135 Waivers From CMS To Alleviate Strain On Medicaid Managed Long-Term Care Plans and Other MCOs As Well As PACE Organizations Amidst Coronavirus Outbreak," Crowell & Moring's Health Law
(March 27, 2020).
Authors: Brian McGovern and Jared Facher.
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"Flurry of Regulatory Activity Driven by COVID-19 Anxiety Impacts Health Plan Requirements and Permissible Actions," Crowell & Moring's Health Blog
(March 17, 2020).
Authors: Gary Baldwin, Kevin B. Kroeker, and Brian McGovern.
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"Health Care – The Growing Risk of Disability Litigation," Crowell & Moring's Litigation Forecast 2020
(January 22, 2020).
Contributor: Brian McGovern.
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"Continuing Care At Home: Uncharted Compliance Territory," McKnight's Senior Living
(December 16, 2019).
Author: Brian McGovern.
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"Court: CMS' Broad Authority to Suspend Medicare Payments Based on Alleged Overpayments beyond Judicial Review until All Administrative Remedies are Exhausted," Pratt's Government Contracting Law Report, Vol. 4, No. 3
(March 2018).
Authors: Brian McGovern and Jared L. Facher.
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"Evaluation Of Graham-Cassidy Bill Applying Principles For Bipartisan Debate And Deliberation," New York City Bar
(September 27, 2017).
Author: Brian McGovern.
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"Statement of Principles for Bipartisan Debate and Deliberation Regarding Health Care Reform Legislation," New York City Bar
(August 8, 2017).
Author: Brian McGovern.
Client Alerts & Newsletters
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"HHS' OIG Tackles Involuntary Nursing Home Discharges,"
Health Care Alert
(December 1, 2020).
Contacts: Brian McGovern, Michelle Chipetine
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"NY DFS Proposes Strict Measures Relating to Mental Health Parity Compliance,"
Health Care Alert
(July 17, 2020).
Contacts: Kathy Hirata Chin, Christopher Flynn, Brian McGovern, Paul Mourning
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"Nursing Homes Again in the Regulatory Hot Seat: COVID-19 Spurs CMS to Increase Infection Control Survey Penalties,"
Health Care Alert
(June 8, 2020).
Contact: Brian McGovern
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"Testing, Testing - Doors Open at Nursing Homes? CMS Offers Guidance on How and When,"
Health Care Alert
(June 1, 2020).
Contacts: Brian McGovern, Michelle Chipetine
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"HHS' Distribution of Provider Relief Funding to Skilled Nursing Facilities Along with New Terms and Conditions Raises Compliance Considerations for Providers,"
Health Care Alert
(May 29, 2020).
Contacts: John T. Brennan Jr., Brian McGovern, Brian Tully McLaughlin, David W. O'Brien, Matthew Vicinanzo
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"Payers, Providers, and Patients – Oh My!: What Providers Should Know about COVID-19 (Part 2 – Federal and State Guidance),"
Podcast: Payers, Providers, and Patients – Oh My!
(March 27, 2020).
Contacts: Brian McGovern, Joe Records, Payal Nanavati
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"Governor Signs Legislation Increasing New York Department of Health Scrutiny Over Nursing Home Sales and Other Transactions,"
Health Care Alert
(January 10, 2020).
Contacts: Stephanie Marcantonio, Brian McGovern, Paul Mourning, Michelle Chipetine
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"Vermont Attorney General’s PFAS Lawsuits Continue Trend of State Government Product Lawsuits Against Industry,"
Environment & Natural Resources Law Alert
(July 2, 2019).
Contacts: Peter C. Condron, Brian McGovern, Peter Gray
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"Open Season: Multi-Agency Report Makes Recommendations to Free the Health Care Sector from Overregulation and Enhance Competition,"
Health Care Alert
(January 10, 2019).
Contacts: Alexis J. Gilman, Brian McGovern, Joe Records
Media Mentions
Firm News & Announcements