CHARLES C. DUNHAM, IV, is an Associate in the Health Care and Life Sciences practice, in the Houston and New York offices of Epstein Becker Green. He provides general counsel and representation to health care providers and health-related companies in a variety of matters, including corporate formation and governance, business operations and transactions, labor and employment, and regulatory compliance. His national health law practice focuses on clinical laboratories, hospitals and health systems, physician group practices, independent practitioner associations, long-term care facilities, and health IT vendors and software developers.
Mr. Dunham’s experience includes the following:
- Fraud and Abuse Counseling and Defense—advising and preparing legal opinions on matters involving the Anti-Kickback Statute, the Physician Self-Referral (Stark) Law, the False Claims Act, and state insurance fraud laws; counseling on Voluntary Refund and Self-Disclosure Protocols; and providing representation in civil and criminal government investigations and in whistleblower (qui tam) actions
- Business Transactions and Contracts—conducting due diligence and compliance reviews; advising on mergers, acquisitions, and joint ventures; and negotiating and drafting various contracts, including professional and management service; employment and independent contractor services; equipment and space leases; marketing and sales arrangements; laboratory services; and software licensing and service arrangements
- Provider Billing and Collections—advising on Medicare and Medicaid enrollment; advising on private network and managed care contracting and out-of-network provider billing; counseling on reimbursement and overpayments; and providing representation in RAC, ZPIC, MAC, CMS, Medicaid, and private payor audits
- Patient Privacy and Cyber-Security—advising on HIPAA Privacy and Security standards; conducting risk assessments; developing compliance policy and employee training programs; providing representation in complaint investigations and government audits; and counseling in privacy breach and remediation
- Compliance Programs—counseling on federal and state regulatory compliance; conducting internal compliance reviews and risk audits and implementing remediation strategies; developing compliance manual and control protocol; and performing training and education programs
- Served as General Counsel to numerous large and small clinical diagnostic and screening laboratories testing in multiple states seeking counsel on compliance with federal and state laws and representation in a variety of business transactions, including mergers and acquisitions, sales and marketing arrangements, and lease agreements.
- Counseled numerous clinical laboratories and pathologists on compliance with Medicare payment and reporting requirements under PAMA and the FDA’s oversight of LDTs.
- Represented a physician group practice in a joint venture with an integrated health system under a mission support arrangement for hospitalist and outpatient specialty physician services.
- Counseled an emerging physician practice offering a blend of telehealth and concierge services on corporate formation and business operations to comply with federal and state laws.
- Represented numerous health care providers in appealing Medicare exclusion, revocation, and deactivation of billing privileges and implementing changes to corporate and regulatory compliance protocol.
- Counseled an independent practice association (IPA) of nursing homes and community long-term care providers on managed care contract and antitrust issues.
- Represented an accountable care organization (ACO) on corporate governance issues, provider participation arrangements, and the implementation of an integrated CMS compliance plan.
- Albany Law School (J.D., cum laude, 2008)
- Health Law Concentration
- Albany Law Review, Senior Editor
- State University of New York at Albany (B.A., magna cum laude, 2004)
- New York
- U.S. District Court, Northern District of New York
- U.S. District Court, Southern District of New York
- U.S. District Court, Southern District of Texas
- U.S. District Court, Western District of New York
- American Bar Association, Health Section
- American Health Lawyers Association
- New York State Bar Association, Health Law Section, E-Health and Information Systems Committee, Co-Chair