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Edward (Ted) Case

Partner

Ted Case is a health care compliance and regulatory attorney with more than 30 years of experience. As a former chief compliance officer with Vanderbilt University Medical Center and the University of Rochester Medical Center (URMC), and former URMC Senior Counsel for Compliance and Reimbursement, Ted knows the challenges facing health care systems and operations. He utilizes this perspective to identify and analyze risk, and counsel clients on how to manage, minimize, and resolve issues while efficiently utilizing resources to achieve objectives.

Ted focuses his practice on complex health care regulatory issues involving Medicare, Medicaid, the 340B prescription discount program, the federal Anti-Kickback, Civil Monetary Penalties and Civil False Claims Act laws.

Certified in Health Care Compliance by the Health Care Compliance Association, Ted also works closely with providers on assessing and managing health care compliance programs, and specifically tailoring programs to areas of most concern and importance.

This experience enables Ted to guide and counsel clients on their interactions with government departments and agencies including the New York State Department of Health (DOH), Office of Inspector General (OIG), U.S. Department of Health and Human Services (HHS), United States Attorney General, the Medicaid Fraud Control Unit (MFCU), Office of Civil Rights (OCR), the Office of Pharmacy Affairs, Department of Justice (DOJ) and the Office of the Medicaid Inspector General (OMIG).

Ted advises a broad array of clients, including hospitals, skilled nursing facilities, physician groups, home care agencies, hospices and early intervention providers, on preparing for and responding to federal and State government agency audits conducted by the Office of Medicaid Inspector General (OMIG), the Office of Inspector General (OIG) and other health oversight agencies and contractors.

Ted also advises clients on:

  • Responding to Medicare, Medicaid and commercial payer audits
  • Responding to Government Investigations
  • Negotiating Provider Agreements
  • Conducting Internal Investigations
  • Resolving Reimbursement Issues

 

PROFESSIONAL & CIVIC AFFILIATIONS

  • Member, Board of Directors, Cancer Support Community Rochester
  • Former Advisory Board Member, Camp Kesem at Vanderbilt University
  • Former Chair, Monroe County Bar Association, Lawyers for Learning Committee
  • Former Board Member, Corn Hill Waterfront and Navigation Foundation
  • Former Chair and Board Member, Pittsford Youth Services

HONORS & AWARDS

  • Selected by peers for inclusion in The Best Lawyers in America® for Health Care Law

NEWS

PRESENTATIONS

  • Panelist, “Published Guidance and Compliance Program Effectiveness,” Healthcare Enforcement Compliance Conference, November 5-7, 2023
  • Co-Presenter, “Paybacks, Clawbacks and Consequences – Where We’ve Been and Where We’re Headed,” The Bonadio Group’s 9th Annual Compliance Solutions Boot Camp, April 20, 2023
  • Presenter, “Risk Assessment and Response In An Age of Growing Expectations,” University of Rochester Medical Center 24th Annual Health Care Compliance Conference, October 27, 2022
  • Co-Presenter, “Pay It Back Now or You’ll Pay Later: Overpayments and Self-Disclosure Obligations and Strategies,” The Bonadio Group’s 8th Annual Compliance Solutions Boot Camp webinar, April 25, 2022
  • Co-Presenter, “Understanding and Managing Clinical Conflicts of Interest,” Health Care Compliance Association, Nashville Regional Conference, November 5, 2021

PRACTICE AREAS

ADMISSIONS

  • New York

EDUCATION

  • Fordham University School of Law, J.D. cum laude
  • State University of New York at Buffalo, Ed.M.
  • Bucknell University, B.A.

Ted Case is a health care compliance and regulatory attorney with more than 30 years of experience. As a former chief compliance officer with Vanderbilt University Medical Center and the University of Rochester Medical Center (URMC), and former URMC Senior Counsel for Compliance and Reimbursement, Ted knows the challenges facing health care systems and operations. He utilizes this perspective to identify and analyze risk, and counsel clients on how to manage, minimize, and resolve issues while efficiently utilizing resources to achieve objectives.

Ted focuses his practice on complex health care regulatory issues involving Medicare, Medicaid, the 340B prescription discount program, the federal Anti-Kickback, Civil Monetary Penalties and Civil False Claims Act laws.

Certified in Health Care Compliance by the Health Care Compliance Association, Ted also works closely with providers on assessing and managing health care compliance programs, and specifically tailoring programs to areas of most concern and importance.

This experience enables Ted to guide and counsel clients on their interactions with government departments and agencies including the New York State Department of Health (DOH), Office of Inspector General (OIG), U.S. Department of Health and Human Services (HHS), United States Attorney General, the Medicaid Fraud Control Unit (MFCU), Office of Civil Rights (OCR), the Office of Pharmacy Affairs, Department of Justice (DOJ) and the Office of the Medicaid Inspector General (OMIG).

Ted advises a broad array of clients, including hospitals, skilled nursing facilities, physician groups, home care agencies, hospices and early intervention providers, on preparing for and responding to federal and State government agency audits conducted by the Office of Medicaid Inspector General (OMIG), the Office of Inspector General (OIG) and other health oversight agencies and contractors.

Ted also advises clients on:

  • Responding to Medicare, Medicaid and commercial payer audits
  • Responding to Government Investigations
  • Negotiating Provider Agreements
  • Conducting Internal Investigations
  • Resolving Reimbursement Issues

 

PROFESSIONAL & CIVIC AFFILIATIONS

  • Member, Board of Directors, Cancer Support Community Rochester
  • Former Advisory Board Member, Camp Kesem at Vanderbilt University
  • Former Chair, Monroe County Bar Association, Lawyers for Learning Committee
  • Former Board Member, Corn Hill Waterfront and Navigation Foundation
  • Former Chair and Board Member, Pittsford Youth Services

HONORS & AWARDS

  • Selected by peers for inclusion in The Best Lawyers in America® for Health Care Law

NEWS

PRESENTATIONS

  • Panelist, “Published Guidance and Compliance Program Effectiveness,” Healthcare Enforcement Compliance Conference, November 5-7, 2023
  • Co-Presenter, “Paybacks, Clawbacks and Consequences – Where We’ve Been and Where We’re Headed,” The Bonadio Group’s 9th Annual Compliance Solutions Boot Camp, April 20, 2023
  • Presenter, “Risk Assessment and Response In An Age of Growing Expectations,” University of Rochester Medical Center 24th Annual Health Care Compliance Conference, October 27, 2022
  • Co-Presenter, “Pay It Back Now or You’ll Pay Later: Overpayments and Self-Disclosure Obligations and Strategies,” The Bonadio Group’s 8th Annual Compliance Solutions Boot Camp webinar, April 25, 2022
  • Co-Presenter, “Understanding and Managing Clinical Conflicts of Interest,” Health Care Compliance Association, Nashville Regional Conference, November 5, 2021

PRACTICE AREAS

ADMISSIONS

  • New York

EDUCATION

  • Fordham University School of Law, J.D. cum laude
  • State University of New York at Buffalo, Ed.M.
  • Bucknell University, B.A.
Case_Edward
Edward (Ted) Case