Anil Shankar is a partner and health care lawyer with Foley & Lardner LLP, and a member of the Health Care Practice. He provides strategic counsel to health care providers as they navigate complex regulatory and reimbursement matters, with a particular focus on the Medicaid program and issues affecting safety net providers.
Anil advises hospitals, clinics, health systems, other providers, managed care plans, and governmental entities on their participation in Medicaid programs. He has helped develop innovative new programs, including Medicaid supplemental payments, quality networks, state and local provider taxes or assessments, and public-private partnerships. He is a leading expert in the use of health care funding to address the social determinants of health and helped to design and implement California’s Whole Person Care pilots, which operate innovative programs for individuals experiencing homelessness, individuals leaving incarceration, individuals with significant mental health disorders and other vulnerable populations. He advises clients on a numerous Medicaid reimbursement and compliance issues, including overpayment investigations and analyses. He has also assisted numerous companies seeking to enter into the Medicaid program. Anil also has deep knowledge of Medicaid managed care and has helped plans and providers evaluate regulatory changes and structure alternative payment methodologies to meet their goals.
Anil heads the firm’s robust 340B Drug Pricing Program practice, which counsels hospital systems, federally qualified health centers, and federal grantees with regard to their obligations and opportunities under the program. He advises clients on compliance and overpayment issues, self-disclosures, internal and governmental audits, 340B contracting, and has helped to restructure entities to maximize 340B Program savings.
Anil has extensive experience advising clients on behavioral health reimbursement, operational, and compliance issues. He has counseled hospital on health systems seeking to expand their behavioral health offerings, including strategic counseling to avoid licensing, regulatory and reimbursement pitfalls. In addition, Anil has helped design systems to protect and share confidential patient information, including behavioral health information. He has successfully obtained millions of dollars of funding for providers and mental health delivery systems through administrative appeals. He works with local behavioral health directors, providers, and managed delivery systems on issues related to funding, reimbursement, program development, and strategic implementation.
During the coronavirus pandemic, Anil has advised hospitals, health systems, governmental entities, nursing facilities and other health care companies with regard to their application, receipt and use of federal relief funds, including the Provider Relief Fund and Coronavirus Relief Fund. He has advised on the development of tracking and documentation systems, counseled providers with regard to both over- and under-payments of funds, and drafted policies and procedures for use and reporting of funds.
- Co-Speaker, “Strategies for Difficulty to Discharge Patients,” California Association of Public Hospitals Member Meeting (December 8, 2021)
- Presenter, “PRF Reporting,” California Association of Public Hospitals and Health Systems (September 16, 2021)
- Co-author, “Payment Dispute with a Medicaid Health Plan? State Not Obligated to Help, According to Federal Court,” Health Care Law Today (July 14, 2021)
- Co-author, “Court Sides with Drug Manufacturers in Ongoing 340B Litigation,” Health Care Law Today (June 22, 2021)
- Co-author, “HHS Extends Timeline for Spending Provider Relief Fund,” Health Care Law Today (June 14, 2021)
- Co-author, “Congress Requires New Medicaid Payment Reporting,” Health Care Law Today (February 23, 2021)
- Co-author, “Congress Overrides HHS Guidance on Use of Provider Relief Funds,” Health Care Law Today (January 11, 2021)
- Co-author, “New HHS Board will Hear 340B Drug Pricing Disputes,” Health Care Law Today (December 15, 2020)
- Co-author, “COVID-19: Provider Relief Fund General Distribution – Phase 3,” Health Care Law Today (October 5, 2020)
- Co-author, “COVID-19: HHS Publishes Long-awaited Reporting Requirements for Provider Relief Fund Recipients,” Health Care Law Today (September 23, 2020)
- Co-author, “COVID-19: Take Two (for some) on Additional DHHS Provider Relief Funding,” Health Care Law Today (August 12, 2020)
- Co-presenter, “COVID-19 Provider Relief Funds – Use of Funds, Attestations, and Risk Analysis,” Foley & Lardner LLP Web Conference (April 28, 2020)
- Co-author, “COVID-19: Understanding HHS’s Plans to Disperse Provider Relief Funds Authorized By The CARES Act,” Health Care Law Today (April 27, 2020)
- Co-author, “COVID-19: Federal Agencies Prepare to Distribute Unprecedented Federal Financial Relief for the Health Care Industry,” Health Care Law Today (March 30, 2020)
- Co-author, “CMS Proposes Enhanced Scrutiny over Medicaid Supplemental Payments,” Health Care Law Today (November 20, 2019)
- Co-author, “Voluntary Behavioral Health Integration in Medi-Cal: What Can be Achieved under Current Law,” California Health Care Foundation (October 21, 2019)
- Co-author, “340B Rate Cuts: DC Court Enjoins and Remands CMS’ 2018 and 2019 Reductions for Hospital Outpatients,” Health Care Law Today (May 22, 2019)
- Co-author, “DC District Court Holds that Medicare Payment Cuts for 340B Drugs Exceeded Agency’s Authority,” Health Care Law Today (January 8, 2019)
- Co-author, “Off-Campus Hospital Outpatient Departments Take Another Hit in CMS Final Rule,” Health Care Law Today (November 14, 2018)
- Author, “340B: DC Circuit Affirms Dismissal of Challenge to 2018 Reimbursement Cuts for 340B Hospitals; New Cuts Already Being Proposed by CMS for 2019,” Health Care Law Today (August 6, 2018)
- Co-author, “A Novel Strategy for Increasing Access to Treatment for Hepatitis C Virus Infection for Medicaid Beneficiaries,” Annals of Internal Medicine (July 17, 2018)
- Co-author, “Policy Brief: A novel strategy for increasing access to Hep C treatment for Medicaid beneficiaries,” USC-Brookings Schaeffer Initiative for Health Policy (May 2018)
- Co-author, “California: Proposed Legislation Regulating Health Care Rates for Payors and Providers,” Health Care Law Today (April 19, 2018)
- Co-author, “California Medicaid Agency Proposes Significant Restrictions on FQHC and RHC Reimbursement,” Health Care Law Today (March 13, 2018)
- Co-author, “SAMHSA Finalizes Second Round of Changes to Federal Substance Use Disorder Privacy Rule,” Health Care Law Today (January 11, 2018)
- Co-author, “Court Rules Against 340B Hospitals, Allows Medicare Reimbursement Cuts to Go Forward,” Health Care Law Today (January 4, 2018)
- Co-author, “Ninth Circuit Victory Opens Door to Medicaid Reimbursement Challenges Based on Equal Access Requirement,” AHLA Bulletin (August 2017)
- New York University School of Law (JD, 2008)
- Standard University (MA, 2001)
- University of California, Los Angeles (BA., 2000)
- Recognized in Chambers USA for his work in health care law in 2022
- Member, American Health Lawyer’s Association
- Member, Los Angeles County Bar Association (Health Law Section)
- Member, American Bar Association (Health Law Section)
- Member, California State Bar