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OVERVIEW

J. Michael Grubbs
Partner

Indianapolis

11 South Meridian Street
Indianapolis, IN 46204-3535

P 317-231-7224

F 317-231-7433

OVERVIEW

J. Michael Grubbs
Partner

Indianapolis

11 South Meridian Street
Indianapolis, IN 46204-3535

P 317-231-7224

F 317-231-7433

Experience is the hallmark of Michael Grubbs’ healthcare industry and legal skill. Michael represents providers before state and federal regulatory agencies and in related litigation. He also helps clients resolve reimbursement and regulatory compliance issues, as well as structure or restructure ventures and transactions to avoid problems before they arise.

OVERVIEW

Experience is the hallmark of Michael Grubbs’ healthcare industry and legal skill. Michael represents providers before state and federal regulatory agencies and in related litigation. He also helps clients resolve reimbursement and regulatory compliance issues, as well as structure or restructure ventures and transactions to avoid problems before they arise.

For decades, Michael has worked as both a respected industry insider and lawyer serving healthcare providers of all kinds. Responsive, smart, creative and practical, Michael knows how healthcare organizations operate and what influences their decision-making process and bottom line. Whether he is representing a provider with a licensing problem before the board, advising on a Medicaid issue, or advocating a complex reimbursement appeal, Michael thrives under the intellectual challenge of applying the complex laws and regulations that govern the healthcare industry to everyday operations, strategic planning, dispute resolution and litigation.

Notably, Michael has also been instrumental in drafting federal and state legislation for the healthcare industry. He has been involved in such issues as Medicaid disproportionate share payments, Medicare geographic reclassification criteria, mental health commitments, and access to health records. He also serves as administrator of the firm’s healthcare practice in Indianapolis.

Prior to the law, Michael worked in various clinical and administrative roles with several healthcare providers in Indianapolis as a certified paramedic for a hospital ambulance division, an assistant administrator with a health maintenance organization, and as chief financial officer of an organization operating group homes for individuals with intellectual disabilities and other developmental disabilities. He was also deputy director of the Indiana Health Care Association, a trade association that represents more than 400 proprietary long-term-care facilities and lobbies the Indiana General Assembly.

EXPERIENCE
EXPERIENCE
  • The firm counsels hospitals, home health agencies, long-term care facilities and individual practitioners in administrative litigation with the Centers for Medicare and Medicaid Services at the United States Department of Health and Human Services and the Indiana State Department of Health.
  • A Barnes & Thornburg attorney assisted a number of hospitals and long-term-care facility clients obtain CMS approval of provider taxes.
  • A Barnes & Thornburg attorney defended group home operator as institutional representative payee against SSA claims for restitution of beneficiaries funds allegedly not used for their benefit.
  • A Barnes & Thornburg attorney prepared joint venture agreements for many transactions involving institutional pharmacies, MRI centers, contract therapy companies, hospitals, physician group practices, and long term care facilities.
  • A Barnes &Thornburg attorney helped a client obtain an order evicting a nursing facility tenant and order to seize Medicare and Medicaid funds to satisfy judgment.
  • A firm attorney advised medical spas regarding scope of practice issues for nurses and unlicensed assistive personnel.
  • A PM&R physician in professional licensing action regarding opioid prescribing and interventional injections for pain management.
  • A team of firm attorneys assisted in the $15.5 million sale of a 225-bed skilled nursing facility, which closed Dec. 31, 2013. The consummation of the transactions resulted from a coordinated effort among firm attorneys who handled all of the health care and related regulatory issues, oversaw all real estate aspects of the transactions, navigated union, labor and related employment matters and helped expedite the closing.
  • A team of firm attorneys, led by Martin Zivitz, assisted in the $15.5 million sale of a 225-bed skilled nursing facility, which closed Dec. 31, 2013. The consummation of the transactions resulted from a coordinated effort among firm attorneys who handled all of the health care and related regulatory issues, oversaw all real estate aspects of the transactions, navigated union, labor and related employment matters and helped expedite the closing.
  • Attorneys represented seller of funeral trusts in state court litigation (Marion County and Indiana Court of Appeals) with State Medicaid Agency about Medicaid eligibility of persons who purchase funeral trusts.
  • Barnes & Thornburg assisted in lobbying efforts that obtained a statutory reclassification of Lake County, Indiana, hospitals to the Chicago, Illinois Medicare wage index.
  • Barnes & Thornburg attorneys assisted a nursing home client convert from government-owned to a private not-for-profit organization.
  • Barnes & Thornburg attorneys drafted and negotiated medical director agreements for physician and hospital clients.
  • Barnes & Thornburg attorneys obtained reversal of State Medicaid Agency order on judicial review in state court (Marion County) prohibiting long-term care facility from using resident personal funds to pay for over-the-counter drugs not covered by Medicaid formulary.
  • Barnes & Thornburg attorneys represented a nursing home in obtaining Trial Rule 41(b) involuntary dismissal of the Indiana Attorney General’s lawsuit on behalf of the Indiana State Department of Health seeking appointment of a health care receiver of a long-term care facility for persons with developmental disabilities.
  • Barnes & Thornburg counsels physicians and other licensed healthcare professionals before Indiana Medical Licensing Board and other health professions boards.
  • Barnes & Thornburg prepared and revised Admission and Life Care Agreements for long-term care facility clients and continuing care retirement communities.
  • Barnes & Thornburg represented a hospital client in a peer review matter involving summary suspension and revocation of privileges of an osteopathic physician
  • Barnes & Thornburg represented a publicly-traded long-term care chain with over 30 hospitals and long-term care facilities in Indiana in state licensure and Medicaid enrollment matters during the company’s reorganization into a real estate investment trust (REIT) and an operating company.
  • Barnes & Thornburg represented several physician clients and were successful with medical staff credentialing and peer review matters.
  • Counsel to Indiana long term care trade association in state court litigation (Hamilton County) against the State Medicaid Agency enjoining Medicaid reimbursement cuts due to failure to follow proper rulemaking procedures.
  • Counsel to Indiana long-term care trade association and individual health facility administrators in state court litigation (Marion County) against State Attorney General and Consumer Protection Division Director for malicious prosecution and abuse of process due to over 100 professional licensing complaints filed the same day against HFAs without any investigation whatsoever in response to newspaper criticism of incumbent Governor during an election year for failure to investigate complaints against HFAs. Settled by appointment of RN/JD reviewer to review each complaint. Following review, all complaints against HFAs were dropped.
  • Counsel to Indiana long-term care trade association in state court litigation (Marion County and Indiana Supreme Court) against Governor and the State Medicaid Agency regarding constitutionality of governor’s veto of bill prohibiting Medicaid rate changes.
  • Firm attorneys prepared a response leading to closure of an FBI investigation of a seller of a long-term care chain resulting from a Medicare intermediary’s report of alleged document destruction to cover alleged Medicare cost report fraud.
  • Firm attorneys resolved concerns of Indiana Securities Division about solvency of CCRC by establishing escrow accounts for refundable entrance fees of current residents.
  • Helped critical access hospital spin off service lines that were formerly treated as non-reimbursable cost centers so as to avoid overhead allocation to those service lines and to increase overhead reimbursement.
  • Issued legal opinion regarding legality of administration of propofol by nurses in gastroenterology office setting.
  • Negotiated employment of cardiac and vascular surgeons physician group that dissolved after its physicians became employees of the hospital and the hospital acquired its physical assets.
  • Negotiated sale of vascular laboratory from cardiac and vascular surgery group to hospital.
  • Obtained favorable settlement of Medicaid overpayment demand for dental services payments due to invalidity of statistical sampling methodology used.
  • Obtained rescission of summary suspension of surgeon for alleged disruptive conduct.
  • Our lawyers helped clients obtain favorable medical necessity rulings from multiple OMHA ALJs in over 150 appeals of Medically Unlikely Edits (MUE) denying Medicare payment for drug screens on patients receiving chronic opioid therapy (COT).
  • Prepared response leading to closure of Medicare intermediary’s investigation of therapy company due to fraud allegations by long term care facility as a pretext to terminate the therapy company contract.
  • Represented nursing home trade association in obtaining CMS approval of state plan amendment and regarding provider taxes.
  • Represented seller of an institutional pharmacy chain to a provider of pharmaceuticals.
  • The firm has represented several county hospitals and hundreds of nursing facilities in arrangements to convert the nursing facilities to non-state government operated nursing facilities (NSGO NF) eligible to make intergovernmental transfers (IGTs) to fund non-federal share of Medicaid upper payment limit (UPL) payments to those facilities.
  • The firm represented a physician in the negotiation of an employment contract, including restrictive covenant, call coverage and compensation.
  • The firm represented various individual health care practitioners and organizations in negotiating and reviewing many employment agreements, leases, management agreements and other contracts.
  • The firm’s client obtained summary judgment in state court (Hamilton County) against hospital ambulance division that sued long term care facilities for ambulance service payments after unilaterally refunding Medicaid payments for those services.
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