A partner with the firm, Kathy has an active litigation practice spanning the areas of health law, federal grants law and government contracts, and corporate law.
In the area of health law, Kathy’s practice focuses on government-sponsored health care programs such as Medicaid, CHIP, Medicare, and the Affordable Care Act, with an emphasis on payment/reimbursement and compliance related issues.
Kathy also advises clients in matters related to Medicaid and Medicare payments and reimbursement, the submission of cost reports, and represents them in litigation in federal court, in administrative appeals within the U.S. Department of Health and Human Services before the Departmental Appeals Board (DAB) and the Provider Reimbursement Review Board (PRRB) and in State court and administrative actions. She also provides reimbursement counseling (including identification, reporting, and repayment of overpayments) with respect to Medicare, Medicaid and private third-party payers.
She advises individual health centers, managed care organizations, and national and state associations on managed care arrangements, compliance with insurance statutes and regulations, corporate affiliations and transactions, employment matters and contractual obligations.
Recognizing that health care providers face increasing government scrutiny, she assists clients in responding to governmental audits and investigations, including subpoenas, OIG and False Claims Act matters. She also assists clients in conducting internal corporate investigations and developing compliance programs.
With respect to federal grants law and government contracts, Kathy handles such matters as Federal and State bid protests on behalf of prospective Government grantees and contractors, and advises grant recipients of a wide variety of Federal and State grant funds concerning grant requirements, cost accounting issues, and cost disallowances. She also assists clients with matters concerning grant/contract interpretation, negotiation, and compliance.
In the corporate law field, Kathy represents small and large businesses, including nonprofit organizations (comprised primarily of professional and trade associations), advising clients on organizational, governance, and risk management issues. Her corporate work also includes responding to Government investigations and audits.
- Obtained a preliminary injunction against a federal agency enjoining the award of a federal grant to the client’s competitor.
- Assisted a number of Federally Qualified Health Centers across the country with the process of setting appropriate rates and in obtaining payment under the Medicaid Prospective Payment System.
- Successfully resolved a grant disallowance approaching $1 million on behalf of a nonprofit, community-based organization.
- Successfully challenged the proposed debarments of a prospective government contractor and of a former federal employee.
- Persuaded the Federal Government to reverse the revocation of a client’s security clearance.
Kathy is dedicated to helping clients navigate complex government rules and requirements so that they can focus on their respective missions and objectives.
Bar/Court Admissions
- District of Columbia
- Maryland
Published Works:
- Editor, American Health Lawyers Association, Member Briefing: An Analysis of Legal Issues—Child and Adolescent Behavioral Health, Part VI: Reimbursement Considerations When Treating Pediatric Patients with Behavioral Health Needs, Aug. 2016.
- Contributor, American Health Lawyers Association, Managed Care Contracting Toolkit, Mar. 2013.
- Kathy S. Ghiladi (Co-author), Managed Care Handbook: A Practical Guide for Health Centers, National Association of Community Health Centers and Feldesman Tucker Leifer Fidell LLP, Jan. 2012.
- Kathy S. Ghiladi (with Benjamin Cohen), Recent Court Decisions Involving FQHC Payments and Methodology, National Association of Community Health Centers, Medicare/Medicaid Technical Assistance Issue Brief No. 92, Jan. 2008.
- Kathy S. Ghiladi (with Jacqueline C. Leifer), Implementing a Risk Management Program for Your Health Center, National Association of Community Health Centers, Information Bulletin No. 8, Risk Management Series, Dec. 2003.
- Kathy S. Ghiladi (with Marcie H. Zakheim), An Introduction to Asset Management for Health Centers, National Association of Community Health Centers, Issue Brief No. 25, Systems Development Series, Aug. 2003.
- Kathy S. Ghiladi (with Jacqueline C. Leifer), Key Contract Issues Facing Health Centers, National Association of Community Health Centers, Information Bulletin No. 2, Nov. 2002.
Representative Cases:
Health Center/FQHC Payment Challenges; Medicaid Payments:
- New Jersey Primary Care Assoc., Inc. v. State of New Jersey Dep’t of Human Serv., 722 F. 3d 527 (3rd Cir. 2013).
- Cedar Riverside People’s Center v. Minnesota Department of Human Services, 2009 WL 1955440 (D. Minn.), Med & Med GD (CCH) P 302,921.
- Three Lower Counties Cmty. Health Ctrs., Inc. v. Maryland, 498 F.3d 294 (4th Cir. 2007).
- El Rio Santa Cruz Neighborhood Health Ctr., Inc. v. HHS, 396 F3d 1265 (D.C. Cir. 2005).
- Chase Brexton Health Servs., Inc. et al. v. Maryland, 411 F.3d 457 (4th Cir. 2005), remanded to D.Md. Dec. 15, 2006.
Federal procurement/Bid protest/Administrative Law:
- LeBoeuf, Lamb, Greene & MacRae, L.L.P. v. Abraham, 347 F.3d 315 (D.C. Cir. 2003).
- LeBoeuf, Lamb, Greene & MacRae, L.L.P., 215 F.Supp.2d 73 (D.D.C. 2002).
- LeBoeuf, Lamb, Greene & MacRae, L.L.P., 205 F.R.D. 13 (D.D.C. 2001).
Recognition
Washington, D.C. Super Lawyer – Health Care (2014 – 2017)
Classes/Seminars Taught:
- American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues (2017) – Medicare Program Integrity and Practice Pointers for Responding to Audits and Investigations
- American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues (2014 and 2015) – FQHCs, RHCs, and Community Health Centers: The Year in Review
- American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues (2011) – FQHCs, RHCs, and Community Health Centers, and Their Potential Role in Health Reform
