Named Texas’ 2018 Lawyer of the Year, Susan Feigin Harris concentrates on the regulatory, business, corporate, governance, compliance, and contracting needs of a diverse group of healthcare clients. She regularly addresses federal and state healthcare regulations, and works with state and federal healthcare agencies involving Medicare and Medicaid licensing, certification, reimbursement, compliance, enforcement, and recoupment actions. Susan’s clients include hospitals, physician groups, lab companies, post-acute providers, and healthcare innovations companies.
She knows a lot about Medicaid reimbursement and understands finance.
She is particularly accessed to provide strategic advice by CEOs, CFOs, and general counsel alike regarding healthcare reform initiatives and healthcare policy at the state and federal level, working to help craft legislative language when necessary.
Susan routinely works in the managed care arena, drafting contracting language, representing clients in disputes, and working to negotiate arrangements, particularly in the commercial and Medicaid managed care space.
With respect to reimbursement issues, Susan is nationally recognized for leading a team of litigators in defeating a CMS policy relating to Medicaid disproportionate share hospital (DSH) payment. She also counsels clients on Medicaid upper payment limit, 1115 waiver programs, graduate medical education reimbursement, and the establishment of value-based payment initiatives in government programs, such as Accountable Care Organization (ACO) models, patient centered medical homes, care coordination entities, and other clinically-integrated networks.
Susan is well-known for her knowledge, in particular, of issues involving children’s hospitals, working to develop Medicaid programmatic solutions, implement legislative and advocacy strategies, and bringing a multi-dimensional set of problem-solving skills to client representation.
Susan serves as an active leader of several law firm coronavirus (COVID-19) task forces, guiding clients through regulatory hurdles and ensuring that compliance with government attestations and audit responses are completed. She has led active efforts to obtain additional legislative funding for providers under the CARES Act and regularly advises clients concerning Medicaid/Medicare and other health certification and licensing, telehealth, provider relief funding, and contracting.
Work with several private equity-backed telehealth companies to ramp up telehealth services for coronavirus testing and provision of services in multiple states. Managed the Medicaid and Medicare enrollment, billing, and compliance issues; work with state agencies to comply with testing and other waivers for COVID-19.
Provide guidance to several clients regarding audits and CARES Act Provider Relief Fund attestation and payments.
Worked with CMS and HHS to obtain funding formula for clients under Provider Relief Fund reflective of Medicaid patients treated.
Represented 12 of the nation’s largest children’s hospitals in securing a nationally significant Medicaid reimbursement litigation win in multiple district courts and several courts of appeals against the government for improperly promulgating a Medicaid policy and for pursing informal guidance as though it was policy. Since 2014, these hospitals, and many others were denied tens of millions of dollars of DSH Medicaid funding.
Secured an appellate victory for two hospitals. The US Court of Appeals for the Eighth Circuit affirmed a district court order enjoining the defendants, the administrator for the Centers for Medicare & Medicaid Services (CMS) and the secretary of the US Department of Health & Human Services (HHS), from enforcing a Medicaid policy set forth in a frequently-asked-questions document (FAQ 33).
Represented a large reference laboratory in obtaining reinstatement of a CLIA license and restricting the arrangement with pathology practices for purposes of moving forward with innovative laboratory testing services.
Represented a unique coalition of the United States’ largest freestanding children’s hospitals to develop special national network options in Medicaid policy for children with complex conditions including legislative language; draft responses to specific legislative interest by Congress, the Congressional Budget Office, and the CMS; and claims and data development. Authored legislation introduced in the US Congress through two congressional sessions, including advocating for clients, working with legislative counsel, and advising a trade association on changes to statutory language and policy impact.
Successfully obtained multiple injunctions on behalf of multiple children’s hospitals in dispute with CMS over disproportionate share hospital (DSH) reimbursement disputes in multiple states, including Minnesota, Virginia, Texas, and Washington.
Represented clients before federal appeals courts in DSH administrative law disputes with CMS.
Conducted discussions with the US Congress and the executive branch to help ensure that the nation’s investment in child health is protected and sustained on behalf of clients. Represents the nation’s major pediatric trade association in efforts to reauthorize the children’s graduate medical education program and support Medicaid and other children’s hospital initiatives.
Created intergovernmental transfer arrangements under the state Medicaid upper payment limit statute for graduate medical education.
Served as a strategic partner and a lead in negotiations with a state Medicaid program to create a care coordination and accountable care entity. Created and negotiated all provider contracts and subcontracts; helped establish and create shared savings formulas; and worked to facilitate and negotiate a contract with the state agency.
Represented clients in Congress during the passage of the ACA, specifically relating to DSH funding, Medicaid reimbursement, pediatric accountable care organization development, and other potential workforce funding opportunities. Established meetings with key congressional members and analyzed, counseled, and drafted alternatives to legislative language.
Facilitated an interface with Center for Medicare and Medicaid Innovation (CMMI) officials relating to the consideration of differing sites of service for certain cardiac catheterization procedures as a means to increase quality outcomes while saving costs. Advised the client on grant proposals submitted to the CMMI.
Analyzed and created multiple hospital-within-hospital arrangements and worked with Medicare fiscal intermediaries to maintain or obtain such certification.
Handled Medicare and Medicaid licensing and certification issues associated with multiple changes of ownership.
Negotiated managed care contracts, provided review and analysis, and drafted multiple provider contracts.
Provided analysis and knowledge relating to managed care narrow network issues, including out-of-network usage nationally.
Provided analysis and guidance relating to health insurance fraud laws.
Consulted on issues associated with research compliance, residency training programs, and other issues specific to academic medical centers.
Counseled hospitals relating to drug diversion and similar CMS conditions of participation compliance issues.
University of Houston Law Center, 1988, J.D.
Duke University, 1985, B.A., with honors in Public Policy Studies and History
Supreme Court of the United States
US Court of Appeals for the Fourth Circuit
US Court of Appeals for the Eighth Circuit
US Court of Appeals for District of Columbia Circuit
US District Court for the Southern District of Texas
Supreme Court of Texas
Band 1, Healthcare: Texas, Chambers USA (2019–2021)
Recommended, Industry focus: Healthcare: service providers, The Legal 500 US (2019–2021)
Recognized, Healthcare/Life Sciences Trailblazer, The National Law Journal (2021)
Named, Modern Healthcare’s “Largest Healthcare Firm” (2016–2021)
MVP, Health, Law360 (2015, 2018)
Litigator of the Week, The Am Law Litigation Daily (2018)
Attorney of the Year, Texas Lawyer (2018)
Recognized, Healthcare: Texas, Chambers USA (2011–2018)
Recognized, Government Relations Practice, Houston, The Best Lawyers in America (2016–2020, 2022)
Recognized, Health Care Law, Houston, The Best Lawyers in America (2006–2022)
Lawyer of the Year, Best Lawyers (2017)
Recognized, Texas Super Lawyers (2008–2021)
Recognized, Top 50 Women (2009, 2011, 2012); Top 100 Lawyers (2011, 2012), Texas Super Lawyers
Board Certified in Health Law, Texas Board of Legal Specialization