Foley & Lardner LLP

Nathaniel M. Lacktman

Senior Counsel

Nathaniel (Nate) Lacktman is senior counsel with Foley & Lardner LLP and a Certified Compliance & Ethics Professional (CCEP). He is a member of the firm's Health Care Industry Team, Senior Living Industry Team, and the Government Enforcement, Compliance & White Collar Defense Practice.

Health Care Compliance and Counseling

Mr. Lacktman advises DMEPOS suppliers, skilled nursing facilities, pharmacies, hospitals, physician practices, health plans, consultants and vendors, and a variety of other health care entities on a range of business and regulatory issues affecting the industry. He handles matters involving contracting fraud and abuse compliance, Medicare and Medicaid reimbursement, self-disclosures and overpayments, the Anti-Kickback Statute, physician self-referrals (the Stark Law), health care marketing rules, HIPAA, corporate compliance programs, licensing, contracting, change of ownership, confidentiality and information sharing, and policies and procedures.

Health Care Enforcement and Litigation

In the litigation and enforcement context, Mr. Lacktman has focused experience in matters involving enforcement actions by state and federal regulators, qui tam actions and the False Claims Act, internal investigations, ALJ hearings and reimbursement disputes, surveys and deficiencies, medical staff peer review, and long-term care. He has represented health care clients in state, federal and appellate courts, administrative hearings, mediations and arbitrations.

Representative Health Care Enforcement Matters

  • Internal investigations for DMEPOS suppliers and skilled nursing facilities regarding potential Medicare and Medicaid overpayments and self-disclosures.
  • Representation of suppliers in Medicare ALJ hearings challenging claim denials for medical necessity.
  • Representation of suppliers in appeals of Medicare, Medicaid, and ZPIC overpayment audits.
  • Representation of skilled nursing facilities and home health agencies in defense of Medicare survey citations and deficiencies.
  • Representation of providers in defense of licensure enforcement actions.
  • Representation of medical device manufacturer in defense of False Claims Act whistleblower lawsuit.

Telemedicine and Telehealth

Mr. Lacktman advises a number of clients – including hospitals, clinics, pharmacies, and physician groups – on the emerging opportunities and regulatory issues presented by telemedicine and telehealth. He has advised clients on the following representative telemedicine matters:

  • Represent provider group before Florida Department of Health on petition for declaratory statement regarding telemedicine arrangement.
  • Advice regarding multistate licensure and practice of medicine issues for direct-to-patient telemedicine videoconferencing. Issues include cross-border compliance, patient consent, practitioner licensure, use of physician extenders, application of telemedicine to consultation exception and call/coverage arrangements, ability to provide telemedicine consults without a prior in-person examination, ability to issue prescriptions following telemedicine consults (controlled substances vs. other prescriptions), and associated recordkeeping requirements.
  • Advice regarding multistate statutes and pending legislation regarding commercial payor coverage of telemedicine services, including any limitations on scope and reimbursement rates.
  • Advice regarding internet pharmacies and federal and state requirements for issuing prescriptions.
  • Advice on e-prescribing practices and application of e-prescribing to telemedicine consults.
  • Advice regarding various teleradiology arrangements and associated licensure and Medicaid reimbursement issues.
  • Advice regarding telepathology arrangements and associated clinical laboratory licensure issues.
  • Negotiate and draft various professional services agreements for telemedicine services.

Education and Accolades

Prior to joining Foley & Lardner, Mr. Lacktman was a judicial extern for the Honorable Ronald S.W. Lew of the United States District Court for the Central District of California. In 2004, he received the Excellence in Preparation for Trial Practice Award from the American Board of Trial Advocates. In 2007, he was one of 12 attorneys selected as Outstanding Healthcare Litigators by Nightingale's Healthcare News. Mr. Lacktman has also been Peer Review Rated as BV® Distinguished™, a mark of excellence in Martindale-Hubbell's peer review rating system.

Mr. Lacktman received his law degree from the University of Southern California School of Law, where he was an editor for the Hale Moot Court Honors Program. Mr. Lacktman is a graduate of the University of Florida (B.A., with honors), where he was a University of Florida Scholar, member of Golden Key National Honor Society, and a member of Sigma Phi Epsilon fraternity.

Community Involvement, Pro Bono and Professional Memberships

Mr. Lacktman is active in the community and is a member of the firm's Tampa pro bono committee. He is a board member of the Gulf Ridge Council Boy Scouts of America. He serves as a volunteer judge in the Teen Court juvenile diversion program through the Hillsborough County Courts, having first volunteered with the Sarasota Teen Court program over 19 years ago. For over a decade, he has been a volunteer judge and coach for undergraduate mock trial competitions. He is a member of the 2010 Class of Leadership Tampa.

He is a member of the American Health Lawyers Association (AHLA), the Health Care Compliance Association (HCCA), the Health Law Section of the Florida Bar, and the Health Law Litigation Committee of the American Bar Association (ABA). Mr. Lacktman is admitted to practice in Florida and California, including the U.S. Court of Appeals for the 9th and 11th Circuits.

Selected Publications

Mr. Lacktman has published numerous articles on health care compliance issues, including the following selections:

  • “OIG Issues 2013 Work Plan,” Legal News: Health Care (October 4, 2012)
  • “OIG Seeks Comments on Changes to Provider Self-Disclosure Protocol,” Legal News: Health Care (June 25, 2012)
  • “DMEPOS Reimbursement Appeals and the Compliance Officer,” HCCA Compliance Today (June 2012)
  • "Proposed Overpayment Regulations Issued for 60 Day Refund Rule,” HCCA Compliance Today (May 2012)
  • “Senate Finance Committee Letter Presents Opportunity for Health Care Businesses,” Legal News: Health Care (May 10, 2012)
  • “CMS Issues Final Rule on DMEPOS Telemarketing and Supplier Standards,” Legal News: Health Care (March 19, 2012)
  • “CMS Issues Proposed Overpayment Refund Regulations for 60 Day Rule,” Legal News: Health Care (February 15, 2012)
  • “Florida Medicaid Reform: Transformative Change,” Collier’s (January 2012)
  • "Transformative Changes Coming to Florida Medicaid," Florida Medical Business (November 2011)
  • "Hospital-DMEPOS Supplier Arrangements and the Anti-Kickback Statute," HCCA Compliance Today (October 2011)
  • "DMEPOS Supplier Marketing Arrangements and HIPAA Compliance," HCCA Compliance Today (September 2011)
  • "DMEPOS Competitive Bidding Program Expands, Includes Competition for National Mail-Order Diabetes Items," American Health Lawyers Association (August 2011)
  • "DMEPOS Supplier Standards and the False Claims Act: Compliance Strategies and Litigation Approaches," HCCA Compliance Today (August 2011)
  • "Florida Enacts Landmark Medicaid Managed Care Legislation: What Health Care Businesses Need to Know," Orlando Medical News (July 2011)
  • "Where the Rubber Meets the Road: How to Actually Live with the New 60-Day Duty to Disclose and Refund Overpayments," American Health Lawyers Association (June 2011)
  • "Compliant DMEPOS Telemarketing: Strategic Approaches and Practical Tips," HCCA Compliance Today (June 2011)
  • "Cold Calls, Hot Lines: DMEPOS Telemarketing and Beneficiary Contact," HCCA Compliance Today (May 2011)
  • "Practical Advice for Privacy Breaches," Health Law360 (April 13, 2011)
  • "Backing Up the Wheelchair: CMS Proposed Rule Withdraws, Relaxes DMEPOS Supplier Standards," Legal News: Health Care (April 5, 2011)
  • "HHS Imposes First-Ever Civil Monetary Penalty for Violation of HIPAA Privacy Rule," Legal News: Health Care (February 23, 2011)
  • "Major Florida Health Care Reforms Proposed by Governor and Legislature," Legal News: Health Care (January 13, 2011)
  • "Sand in Your Genes: Opportunities and Challenges for Personalized Medicine in Florida," Tampa Bay Medical News (January 2011)
  • "Florida Agencies in the Cold as Governor Orders Freeze on All New Regulations," Legal News: Health Care (January 11, 2011)
  • "2011 OIG Work Plan Expands Health Reform Reviews," [DMEPOS and Part B portions] Legal News: Health Care (October 13, 2010)
  • "Even Wheelchairs Need Tune-Ups: CMS Releases Final Rule Revising DMEPOS Enrollment and Participation Standards," American Health Lawyers Association (August 2010)
  • "Waiting is the Hardest Part: Despite Physician's 'Obstructive' Behavior and Refusal to Cooperate, Hearing Officer Lacks Authority to Terminate Peer Review Hearing," California Health Law News (Spring 2009)
  • "Understanding the Current State of Peer Review in Florida," The Florida Bar Journal (May 2009)
  • "Guns, But No Bullets: California Supreme Court Limits Powers of Medical Staff Peer Review Hearing Officer in Mileikowsky v. West Hills Hospital & Medical Center," AHLA Health Lawyers Weekly (April 17, 2009)
  • "Application of Hospital Rule Requiring Board Certification Was Unreasonable and Arbitrary Because Short Deadline Made It Impossible For Physician to Comply," California Health Law News (Winter 2009)
  • "OIG Issues Supplemental Compliance Program Guidance for Nursing Facilities: Quality of Care is Top Risk Area," AHLA Health Lawyers Weekly (October 10, 2008)
  • "Quality of Care and Compliance: Existing Challenges and First Steps for Hospitals," HCCA Compliance Today (October, 2008)
  • "Peer Review Advice for Healthcare Systems: California Court of Appeal Ruling in Smith v. Selma," AHLA Health Lawyers Weekly (September 19, 2008)
  • "Draft Supplemental Compliance Program Guidance for Nursing Facilities," HCCA Compliance Today (August 2008)
  • "Smith v. Selma: Guidance for Peer Review Bodies," Health Law360 (August 28, 2008)
  • "Illinois Law Prohibits Percentage-Based Compensation Arrangements Between Physician Groups and Medical Billing Companies: Parallels in Federal, State Perspectives," Legal News: Health Care (July 11, 2008)
  • "U.S. Attorney Announces Permanent, Lifetime Exclusion for Quality of Care Failures," Legal News: Health Care (June 18, 2008)
  • "Florida Peer Review After Amendment 7: What Protections Are Left?" Florida Medical Business (June 10, 2008)
  • "Peer Review Protections After Amendment 7," Health Law360 (May 14, 2008)
  • "California Supreme Court Denies Review of Post-Claims Underwriting Case: Health Plans Must Conduct Pre-Issuance Investigation or Show Enrollee Deception Before Cancelling Policies," California Health Law News (Spring 2008)
  • "CMS' Special Focus Facility Initiative and Nursing Home Compare," HCCA Compliance Today (February 2008)
  • "The Quality of Care Cerberus: Payments, Public Reporting, and Enforcement," ABA The Health Lawyer (December 2007)
  • "Compliance and the Quality of Care Revolution: Fitting the Pieces Together in the Government's New Enforcement Landscape," AHLA Health Lawyers News (September 2007)
  • "Healthcare Arbitration Agreements Face New Attacks: How Providers Can Respond and Draft Effective Agreements," California Health Law News (Summer 2007)
  • "Who's Watching? Strategic, Legal and Operational Issues for Long Term Care Facilities Considering Video Surveillance Monitoring," ABA Health Law Litigation (Summer 2007)
  • "Another Blow to Medical Staff Peer Review Privilege," Health Law360 (July 2, 2007)
  • "CMS Guidance Expands Emergency Services Requirements For Medicare Participating Hospitals," Legal News: Health Care (April 27, 2007)
  • "Blurring the Line Between Termination and Exclusion? CMS Publishes Proposed Rule Revising Medicare Appeals Process and Implementing Three-Year Reenrollment Prohibition for Revoked Providers," Legal News: Senior Living & Long-Term Care (Spring 2007)
  • "What's In Your Wallet? OIG Advisory Opinion Approves Credit Cards Rewards Program at Nursing Home," Legal News: Senior Living & Long-Term Care (Spring 2007)
  • "States Address Evolving Long-Term Care Needs with Regulatory Changes and New Licensure Categories," Legal News: Senior Living & Long-Term Care (Spring 2007)
  • "New, Stricter CMS Requirements for Physical Restraints Have Facilities in a Bind," Legal News: Senior Living & Long-Term Care (Winter 2007)
  • "Health Care Providers and the Automatic Stay: Is Medicare Termination Different than Exclusion?" American Bankruptcy Institute Journal (November 2006)
  • "Arbitration Agreements for Health Care Providers: Recent Legal Changes and Strategies to Consider," ABA Health Law Litigation (Fall 2006)
  • "OIG Report on Status of Nursing Home Complaint Investigations," Legal News: Senior Living & Long-Term Care (Summer 2006)
  • Mr. Lacktman has also been published in the Medical-Legal News, the Entertainment Industry Litigation Reporter, the E-Business Law Bulletin, and the Software Law Bulletin

Selected Presentations and Media

  • “Effective Compliance Programs for DME Suppliers,” HCCA webinar (Dec 2012)
  • “Establishing Healthcare Compliance Programs as Mandated by PPACA,” (Nov 2012)
  • "Compliance Programs, Overpayments and Health Reform in the DME Industry,” MedTrade 2012, Atlanta, GA (Oct 2012)
  • “Motivating Patients with Incentives, Not Inducements or Kickbacks,” Health 2.0 2012 Convention, San Francisco (Oct 2012)
  • “Home Health & Hospice Compliance Programs, Overpayments and Health Reform,” National Association for Homecare & Hospice (NAHC) Annual Meeting, Orlando, FL (Oct 2012)
  • “Overpayments, Obligations, Original Sources, and Other Recent Amendments to the False Claims Act: Practical Advice and Strategic Approaches,” Association of Corporate Counsel Health Law Committee (June 5, 2012)
  • "Four of a Kind: Perspectives on Quality of Care from Four Aces," Health Care Compliance Association (HCCA) 2012 Compliance Institute, Las Vegas (May 2012)
  • “Home Health & Hospice Compliance Programs, Overpayments and Health Reform,” National Association for Homecare & Hospice (NAHC) Policy Conference and Law Symposium, Washington, D.C. (March 2012)
  • "Corporate Compliance and Self-Disclosure of Overpayments in Long Term Care," AHCA/NCAL Independent Owner Leadership Conference (March 2012)
  • "Compliance Programs, Overpayments and Health Reform in Long-Term Care," New England Alliance of the American College of Health Care Administrators (ACHCA), Vermont (January 2012)
  • "Hot Topics in DMEPOS Compliance," American Health Lawyers Association (November 2011)
  • "Overpayments Under the 60 Day Rule – Practical Advice and Strategic Approaches," Hillsborough County Bar Association Health Law Section, Tampa (November 2011)
  • "DMEPOS Beneficiary Telemarketing and Contact Rules," Medical Equipment Suppliers Association (MESA), Fall 2011 Conference, Dallas (September 2011)
  • "Motivating Patients with Incentives, Not Inducements or Kickbacks," Health 2.0 2011 Convention, San Francisco (September 2011)
  • "Health Reform and Effective Corporate Compliance in Long Term Care," Florida Association of Homes and Services for the Aging, 48th Annual Convention and Exposition, Orlando (July 2011)
  • "Accountable Care Organizations: What’s in it for Florida Hospitals?" Florida Medical Business (May 2011) (quoted)
  • "Will Nurses Lead Florida’s Medical Homes?" Florida Medical Business (May 2011) (quoted)
  • "Compliance with Medicare DMEPOS Supplier Standards: Understanding Operational Requirements, Medicare Enrollment and Billing Privileges, and False Claims Act Considerations," Strafford Webinars (April 7, 2011)
  • "Hospital Compliance Under the OIG 2011 Work Plan: Preparing for Heightened Federal Scrutiny of Provider-Based Status, Quality Reporting and Reimbursement," Strafford Webinars (March 17, 2011)
  • "Clinical Trials Seen as Driving Economic Sector," Tampa Bay Business Journal (January 28, 2011) (quoted)
  • "Corporate Compliance in Long Term Care," Florida Association of Homes and Services for the Aging, 47th Annual Convention and Exposition, Boca Raton (July 27, 2010)
  • "OIG Ruling Sets Stage for Aligning Incentives to Improve Quality," Report of Medicare Compliance (November 17, 2008) (quoted)
  • "What Health Care Executives Need to Know About Quality of Care," Foley & Lardner LLP, Orlando (October 28, 2008)
  • "Enhancing Quality and Compliance," Quality Colloquium, Harvard University (August 19, 2008)
  • "The Amendment 7 Challenge: Is a PSO Hype or Hope?" Foley & Lardner LLP, Orlando (April 29, 2008)
  • "Hospitals Face Many Hurdles With Growing Role of Quality," Report of Medicare Compliance (March 24, 2008) (quoted)
  • "Quality of Care: Important Changes to Reimbursement and Enforcement," Foley & Lardner Health Care Friday Focus Web Conference (March 28, 2008)
  • "Quality of Care: Transforming Health Care Through Payment Reform, Public Reporting and Enforcement," Healthcare Financial Management Association, Washington/Alaska Chapter (November 29, 2007)
  • "Quality of Care: Transforming Health Care Through Payment Reform, Public Reporting and Enforcement," Healthcare Financial Management Association and Nebraska Hospital Association (November 1, 2007)
  • "Recent Developments in Medical Staff Law: The Patient Safety and Quality Improvement Act: A New Opportunity to Protect Peer Review Information," California Association of Medical Staff Services, Long Beach Chapter (October 27, 2006)
  • "Advance Health Care Directives," Beverly Hills Bar Association (March 25, 2006)

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