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Albert W. Shay

Partner

albert.shay@morganlewis.com

Washington, DC Phone +1.202.739.5291 Fax +1.202.739.3001

1111 Pennsylvania Ave. NW//Washington, DC 20004-2541//United States

Albert W. Shay focuses his practice on counseling healthcare companies of all types on regulatory, fraud and abuse, Stark law, Medicare reimbursement, and transactional matters. Al devotes a substantial portion of his practice to corporate compliance issues, including internal and government investigations, and has experience representing clients before regulatory agencies such as the Centers for Medicare and Medicaid Services (CMS), the US Department of Health and Human Services’ Office of Inspector General, and the Provider Reimbursement Review Board.

Al advises hospitals, physician groups, and ancillary service providers in areas such as physician self-referral (i.e., the federal Stark law and its state law counterparts), federal fraud and abuse, and regulatory compliance. He frequently serves as compliance counsel for hospitals and other healthcare companies, including advising clients that are subject to Corporate Integrity Agreements. Al also helps healthcare businesses address complex fraud and abuse investigations, voluntary self-disclosures, overpayment recoupment efforts, and other compliance reviews, and he often negotiates resolutions with representatives of the CMS and/or HHS’s Office of Inspector General. Al advises numerous post-acute care providers and serves as the General Counsel for the National Association of Long Term Care Hospitals.

Al also represents many hospitals before administrative agencies and in federal courts. This includes work in connection with Medicare reimbursement and in certification appeals before the Provider Reimbursement Review Board, the CMS Administrator, and the federal courts. He has successfully appealed Medicare reimbursement matters in the US Court of Appeals for the First Circuit and the US Court of Appeals for the Eighth Circuit.

A frequent writer and speaker, Al often talks and writes on fraud and abuse matters, as well as the application of the federal physician self-referral law (Stark law). An active member of the American Health Lawyers Association (AHLA), he previously served as the vice chair of the AHLA’s fraud and abuse, self-referrals, and false claims substantive law committee.

Before joining Morgan Lewis, Al was a partner at an international law firm, where his work focused on the healthcare industry.


Awards and Affiliations

Recommended, Healthcare: service providers, The Legal 500 US (2021)

Named, Modern Healthcare’s “Largest Healthcare Firm” (2016–2021) 

Ranked, Healthcare, District of Columbia, Chambers USA (2017–2021)

Recognized, Health Care Law, Washington, DC, The Best Lawyers in America (2015–2020, 2022)

Recognized, Best Lawyers, Washingtonian magazine (2013)

Leadership Committee Co-Chair, American Health Lawyers Association’s Fraud and Compliance Forum Program Planning Committee (2021)

Former Vice Chair, Fraud and Abuse, Self-Referrals, and False Claims Substantive Law Committee, American Health Lawyers Association

Peer rated "AV" by Martindale Hubbell

Admissions

  • District of Columbia
  • Virginia

Education

  • Saint Louis University, 1987, M.H.A.
  • Saint Louis University School of Law, 1987, J.D., magna cum laude
  • University of Maryland, 1982, B.A.

Sectors

  • Healthcare
  • Life Sciences

Services

  • Healthcare & Life Sciences Litigation
  • Healthcare Transactions
  • Litigation, Regulation & Investigations
  • Government Contracts
  • Washington Strategic Government Relations & Counseling
  • White Collar Litigation & Government Investigations
  • False Claims Act & Qui Tam Litigation

Regions

  • North America

Events

6/28/2021 - AHLA’s Annual Meeting 2021 – Get Your Group in Order: Ensuring Group Practice Compliance with the Physician Self-Referral Law
2/25/2021 - Fast Break: Regulatory Sprint to Coordinated Care
4/14/2020 - COVID-19 Healthcare Provider Update Webinars
4/2/2020 - COVID-19 Healthcare Provider Updates: Physician Practices
3/24/2020 - COVID-19 Healthcare Provider Updates: Medical Waivers
10/30/2019 - Fast Break: Regulatory Sprint Part 1
6/23/2019 - 2019 AHLA In-House Counsel Program
2/4/2019 - AHLA Physicians and Hospitals Law Institute 2019
9/26/2018 - AHLA Fraud and Compliance Forum 2018
8/23/2018 - Fast Break: Stark Lessons for Physician Practice Acquisitions
6/26/2017 - AHLA Annual Meeting 2017
7/19/2016 - CMS Implementation of Section 603 of the Bipartisan Budget Act: Implications for Provider-Based Clinics
6/26/2016 - 2016 AHLA Annual Meeting and In-House Counsel Program
2/23/2016 - CMS Finalizes 60 Day Overpayment Rule
10/1/2015 - OIG and CMS Voluntary Self Disclosures: Weighing the Risks and Rewards of Self Reporting
3/25/2015 - Institute on Medicare and Medicaid Payment Issues 2015
10/6/2014 - American Health Lawyers Association Fraud and Compliance Forum
9/29/2013 - AHLA/HCCA Annual Fraud and Compliance Forum
6/24/2012 - AHLA In-House Counsel Program and Annual Meeting
10/9/2011 - Cerner Health Conference 2011
3/31/2011 - West LegalEdCenter's Medical Necessity of Cardiac Implants: The New Enforcement Priority
6/21/2010 - ACI's National Legal and Compliance Summit on Healthcare Enforcement
3/14/2010 - The Healthcare Roundtable for General Counsel & CMOs

News

6/1/2020 - Wave of Whistleblower Suits Predicted Over Virus Relief Aid, Bloomberg Law
10/14/2019 - 3 Areas of the Stark Overhaul Likely to Give Providers Compliance Headaches, Fierce Healthcare
1/7/2014 - Twelve Morgan Lewis Partners Named to Washingtonian’s Best Lawyers Listing

Publications

3/11/2021 - Recap on Our February Fast Break: Regulatory Sprint to Coordinated Care
11/24/2020 - HHS Regulatory Sprint Crosses the Finish Line: New Stark and Anti-Kickback Rules Forecast Big Changes for Patients and Value-Based Care
6/18/2020 - DC Circuit Court: CMS Rule on Drug Pricing Disclosure Exceeds Statutory Authority
5/18/2020 - CMS and OIG Offer Additional Details on Blanket Waivers and AKS Policy Statement
4/14/2020 - Stark Law and Anti-Kickback Statute Enforcement: For HHS, It’s Not Business as Usual
3/23/2020 - Retail Pharmacies Are Rising to the COVID-19 Challenge
10/30/2019 - Advancing Value-Based Care: The Proposed Stark Exceptions and AKS Safe Harbors
10/28/2019 - INSIGHT: Proposed Stark Exceptions and Anti-Kickback Safe Harbors—Similar, But Different By Design, Bloomberg Law
10/24/2019 - Register for Fast Break: Regulatory Sprint – Part 1
10/9/2019 - OIG and CMS Coordinate Seismic Change to Fraud and Abuse Laws—What It Means for the Health Industry
5/23/2019 - Healthcare Team Contributes to AHLA Health Care Compliance Legal Issues Manual
April 2019 - Regulatory Advice and Liability Issues, Chapter Seven, AHLA Health Care Compliance Legal Issues Manual
6/29/2018 - Is Stark Law Reform or Repeal in the Offing?
5/14/2018 - CMS Publishes Six Proposed Medicare Payment Rules: What It All Means
1/26/2018 - Pay to Play: The End of Net Neutrality and Its Effect on Telehealth
10/4/2017 - Retail Pharmacy: OIG Signals It’s Okay to Reward Again
September 08, 2017 (Updated September 18, 2017) - Hurricane Recovery Client Alert: Regulatory Relief for Healthcare Providers in Disaster Areas
5/22/2017 - Penalizing Physicians for Causing Hospitals to Forego Payment
11/10/2016 - Preparing for an ACA Rollback: How to Get Paid for Treating the Uninsured
8/8/2016 - Provider-Based Rule and Stark—Is Joint Compliance Impossible in 2017?
7/6/2016 - Senate Finance Committee Examines Repeal of the Stark Law
6/8/2016 - When The Government Misinterprets Its Own Medicare Rules, Law360
2/17/2016 - The 60-Day Rule Is Final: Assessing Your Organization’s Safeguards
2/13/2016 - Stark Law Clarifications Bring Little Relief to Florida Health Care Providers, Daily Business Review
2/11/2016 - CMS Finalizes 60 Day Overpayment Rule
12/9/2015 - Stark Law Clarifications Bring Both Benefits and Potential Challenges
10/28/2015 - New Budget Bill May Signal End of Provider-Based Status
7/27/2015 - FDA Regulation of Hospital-Developed Technologies
7/9/2015 - CMS Releases 2016 Physician Fee Schedule
6/23/2015 - Minimizing Financial Risks from Clinical Trial Subject Injury
6/2/2015 - Sixty Days of Gray: Medicare and Medicaid Refund Requirements
12/2/2014 - The OIG Work Plan: Does OIG Always Know Best?
10/29/2014 - OIG’s Proposed Safe Harbors and CMPL Rules: A Different Way of Thinking?, BNA’s Health Care Fraud Report
5/21/2014 - Fair Market Value in Hospital and Physician Transactions, presented as a Strafford CLE program
9/29/2013 - What's New in Hospital Fraud & Abuse, presented at the AHLA Fraud and Compliance Forum
4/17/2013 - HHS OIG Issues Revised Self-Disclosure Protocol
4/16/2013 - Protections to Be Extended for Electronic Health Record Donations
March 2013 - Final Sunshine Act Arrives: Now the Hard Part
12/1/2011 - FTC/DOJ Final Policy Statement on Accountable Care Organizations: Important Antitrust Issues Remain Unanswered, BNA's Health Law Reporter
10/31/2011 - FTC/DOJ Final Policy on Accountable Care Organizations: Important Antitrust Issues Remain Uncertain for Healthcare Collaborations
9/28/2011 - Medical Necessity of Cardiac Implants: The New Enforcement Priority (a West Legal Education webinar)
6/13/2011 - Seventh Circuit Embraces Use of “One Purpose” Standard Under Anti-Kickback Statute
10/28/2010 - Overview of Government Program Integrity Functions and Enforcement Authorities, presented at the National Association for Children's Behavioral Health Technical Meeting 2010
6/21/2010 - Establishing a Flexible Template for a Stark Analysis, presented at the American Conference Institute’s National Legal and Compliance Summit on Healthcare Enforcement
4/13/2010 - Healthcare Reform Law: Issues Affecting Hospitals and Health Systems