Joshua M. Gilbert
Joshua Gilbert is a health care attorney who regularly assists hospitals, hospices and other health care providers in a variety of operational, transactional and regulatory matters. Josh’s practice specifically includes Medicare and Medicaid reimbursement issues and cost report appeals, EHR implementation and Meaningful Use compliance, and HIPAA privacy and security. Experienced in a variety of federal and state regulatory issues, he frequently advises on physician employment and services contracting, day-to-day operational issues, and compliance matters for hospice and long-term care facilities.
Presentations & Published Works
- Author, "CMS Makes Big Changes to RAC Program," 2015
- Author, "New CMS Guidance and FAQs on Switching Electronic Health Records Vendors," 2015
- Author, "In-depth Summary of Stage 3 Meaningful Use and CEHRT Rules," 2015
Bar Admissions & Activities
- Admitted, State of Ohio, 2014
- Member, Ohio State Bar Association
- Member, Columbus Bar Association
- University of Pennsylvania Law School (J.D.), 2014
- Wharton School at the University of Pennsylvania (Certificate in Business, Economics and Public Policy), 2014
- Taylor University (B.A., Political Science), 2011
Financing and conversion of public hospital to nonprofit business
Assisted Adams County Regional Medical Center in its conversion from a county-owned hospital to a private health care provider. The transaction required obtaining bond financing for the acquisition and conversion of the hospital facilities, real property and assets, and resulted in the continuation of local care for Adams County residents.
Hospital system arbitration
Represented a hospital system in multiple arbitration proceedings in a dispute with national payor relative to the implementation of sequestration cuts imposed following passage of the budget deficit reduction act.
Medicare reimbursement matters
Represent large teaching hospitals and other non-teaching hospitals on Medicare reimbursement matters and cost report appeals, which include appeals of administrative agency decisions and various court appearances.
CMS meaningful use audits
Advised hospitals responding to meaningful use audits of the Centers for Medicare & Medicaid Services (CMS) electronic health record incentive payment program, which required analyzing compliance with regulatory requirements for receiving such payments, assisting with preparation of responses and guiding hospitals through the audit appeal process, when necessary.
Management services organization development
Served as lead counsel to an Ohio-based health network in developing a unique physician-led management services organization (MSO) providing day-to-day operation and management of multiple breast health centers. This unique MSO also developed a clinically integrated incentive strategy within the network of primary care and OB-GYN physicians to implement a physician-designed evidence-based patient protocol to enhance breast health, early detection and prevention in the health network's market area.