Overview

Anil Shankar is a partner with Foley & Lardner LLP. He focuses his practice on complex regulatory and reimbursement matters, with a particular focus on the Medicaid program and issues affecting safety net providers. He has conducted extensive research and advised clients with regard to the implementation and development of Medicaid demonstration projects, and has analyzed opportunities for, and helped to implement, Medicaid supplemental payments. Mr. Shankar routinely advises clients on new developments in the Medicaid program, including issues related to Medicaid managed care and to behavioral health services. Mr. Shankar also advises clients on matters relating to the 340B drug pricing program. He is a member of the firm’s Health Care Industry Team.

During law school, Mr. Shankar worked as an extern for Justice Earl Johnson on the California Court of Appeal (Second District).

Education

Mr. Shankar received his law degree from the New York University School of Law (J.D., 2008), where he received the John Bruce Moore award for his scholarship. He earned his M.A. from Stanford University in 2001 and his B.A. from the University Of California, Los Angeles in 2000.

Admissions

Mr. Shankar is admitted to practice in California.

Publications and Presentations

  • “Ninth Circuit Victory Opens Door to Medicaid Reimbursement Challenges Based on Equal Access Requirement,” AHLA Bulletin, August 2017
  • “Proposed Rule Would Slash Medicare Payment for 340B Drugs,” Health Care Law Today, July 20, 2017
  • “Senate Releases Repeal and Replace Legislation on ACA: The Better Reconciliation Act of 2017,” Health Care Law Today, June 2017
  • “CMS Proposes Rule to Implement Parity Requirement for Mental Health and Substance Use Disorder Benefits in the Medicaid and CHIP Programs,” AHLA e-Alert, April 2015
  • Contributing author, “OIG 2015 Work Plan, Part 1: Do fewer projects mean a sharper focus?” HCCA Compliance Today, January 2015
  • Co-author, “HHS Withdraws Proposed 340B Drug Pricing Program ‘Mega Regs’: Further Guidance Forthcoming,” Health Care Law Today (November 18, 2014)
  • Co-author, “340B Drug Pricing Program Interpretative Rule Survives (for Now),” Health Care Law Today (September 2, 2014)
  • Co-author, “HRSA Issues Interpretive Rule on 340B Drug Pricing Program,” Health Care Law Today (July 23, 2014)
  • Co-author, “Recent Court Decision May Impact 340B Drug Pricing Program ‘Mega-Reg,’" Health Care Law Today (June 23, 2014)
  • Co-author, “OIG Publishes Report Identifying Issues with 340B Contract Pharmacy Arrangements,” Foley & Lardner LLP Legal News Alert: Health Care, February 12, 2014
  • Co-author, “340B Drug Pricing Program Developments in the New Year,” Foley & Lardner LLP Legal News Alert: Health Care, January 13, 2014
  • Co-author, “Medicaid in 2014: Implementation of Changes Made by the Affordable Care Act,” The RAP Sheet, a publication of the American Health Lawyers Association Regulation, Accreditation, and Payment Practice Group, November 2013
  • Co-author, “340B Drug Pricing Program Update: Hospital Recertification and Recent Audit Activity,” Foley & Lardner LLP Legal News Alert: Health Care, August 19, 2013
  • Co-author, “340B Drug Pricing Program: Recent Developments,” Foley & Lardner LLP Legal News Alert: Health Care, April 18, 2013
  • Co-author, “California’s Medi-Cal Program Implements Affordable Care Act Fraud, Waste, and Abuse Provisions,” Foley & Lardner LLP Legal News Alert: Health Care, November 27, 2012
  • Co-presenter, “Recent Developments in 340B Drug Pricing Program Compliance and Enforcement,” Foley & Lardner LLP Web Conference, October 18, 2012
  • Co-author, “GAO Identifies Need for Improved HRSA Oversight of Health Center Program,” Foley & Lardner LLP Legal News Alert: Health Care, July 26, 2012
  • “Increased Scrutiny of 340B Drug Pricing Program Compliance and Enforcement,” Foley Legal News Alert, May 2012 
  • “CMS Issues Final Rule Requiring States to Develop Medicaid Recovery Audit Contractor Programs,” Foley Legal News Alert, September 2011 
  • “CMS Solicits State Participation in Medicaid Emergency Psychiatric Demonstration,” AHLA e-Alert, August 2011 
  • “Health Reform Legislation Expands Coverage Through Medicaid,” Foley Legal News Alert, April 2010 
  • “Landmark Health Care Reform Legislation Significantly Expands Government’s Ability to Fight Fraud, Waste, and Abuse,” Foley Legal News Alert, March 2010
  • "New Developments in Payment and Public Reporting of Quality of Care," Compliance Today, March 2009
  • "OIG Issues Green Light to Hospital "Pay for Quality" Arrangement," Compliance Today, January 2009
  • "Hospital-Physician Alignment Models in California," California Health Law News, Winter 2008

Representative Matters

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Foley represented Care 1st Health Plan, a California Medicaid and Managed Care HMO, and its shareholders in the share of stock to Blue Shield of a California for $1.2 Billion.
Foley provided advise on various reimbursement and financing matters under Medicaid, the Section 1115 Medicaid Demonstration, and health care reform. Advice includes: the structuring of federal and local government financing mechanisms, ongoing compliance with Medicaid law and waiver terms and conditions, strategizing on future demonstration waiver program and funding streams, and financing and delivery organization issues associated with the Medicaid expansion population.
Represented California Association of Public Hospitals and Health Systems (CAPH), on behalf of 20 public hospital systems, in the implementation of the Medicaid Bridge to Reform Demonstration under Section 1115 of the Social Security Act. Specific roles included negotiations and drafting of the implementing state statutes, policy guidances, Demonstration and waiver agreements with the Centers for Medicare and Medicaid Services and California Department of Health Care Services, and the structuring of federal and local government financing mechanisms, and ongoing compliance. The key Demonstration components include a reimbursement pool for uncompensated care costs for the uninsured, incentive payments for delivery system reform activities, and county programs providing coverage to low-income individuals under California's early implementation of the Affordable Care Act Medicaid expansion. The matter is still ongoing, and, as the current waiver term end-date approaches, new efforts are underway with respect to an extension of the demonstration with new and innovative finance and service improvement components.

Capabilities