Overview

As the nation’s aging population drives the demand for patient-centered and value-based health care, attorney Clifford Barnes is advising post-acute health care providers, other providers, and Medicaid managed care companies on meeting the need.

Cliff has practiced health care law since its inception; his big-picture and practical insights add value to clients’ innovations, from product inception to rollout to ongoing operation.

Clients rely on his guidance in acquisitions, mergers, joint ventures, and related regulatory compliance as they expand access to care and their businesses. The transformation of hospices, home health care, palliative services, and nursing homes comes with new risks. Cliff is identifying—and mitigating—the exposure clients face, guiding them through organizational restructures and negotiating strategic partnerships and agreements with programs. Cliff is also advising clients on health equity and value-based issues and agreements. Boards of directors and company leaders value his business practicality and embrace of good opportunities. Startup companies also rely on Cliff’s bootstrap-friendly, outside general counsel advice to bring their products and services to market. In addition, Cliff’s work includes advising clients on the following: state regulatory issues for licensing and Certificate of Need, Medicaid Managed Care contracting, and Medicaid suspensions.

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Cliff’s former service as an executive assistant to the Commissioner of Health in the New York City Health Department spurred his interest in health care law and underserved communities. A co-founder of the Medicaid Health Plans of America, Inc., Cliff is focusing his industry leadership on the intersection of Medicaid and managed care with expansion of health equity by members of the national trade association. Cliff shares clients’ commitment to the public and the creation of systemic solutions to health care challenges.

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Focus Areas

Experience

  • Terminated successfully a suspension of Medicaid payments by the D.C. Department of Health Care Finance, based upon fraud claims, for a behavioral health company.
  • Negotiated successfully, on behalf of a home health care agency client, a settlement agreement with the D.C. Department of Health Care Finance (DHCF), ending the suspension of Medicaid payments due to the client. Cliff assisted the client in settling the matter within two months of the client’s receipt of the DHCF’s Notice of Suspension.
  • Helped an investment firm acquire two skilled nursing facilities and two long-term acute care facilities. Cliff and his team advised the investment firm on the health regulatory aspects of the transaction.
  • Represented a client providing specialized inpatient stabilization and withdrawal management services in two matters. First, Cliff obtained from the U.S. Department of Health and Human Services’ Office of Inspector General a waiver of successor liability under the client’s Corporate Integrity Agreement (CIA) in connection with the acquisition of the client’s assets by a national provider of behavioral health services. Second, Cliff secured the suspension of the client's obligations under its CIA.
  • Served as regulatory counsel to advise a community hospital client seeking to become a region-wide proton therapy provider on the regulatory process, including the Certificate of Need (CON), for the establishment of proton therapy stations. Cliff developed the strategy, prepared regulatory filings, and interfaced with the regulators, leading the government to approve three proton stations.
  • Assisted a home health care provider in successfully entering into an agreement to settle a disputed confessed judgment liability of more than $930,000 for the sum of $428,333.28.

Recognition

  • The Best Lawyers in America, Corporate Compliance Law, Health Care Law (2023-2024)
  • Savoy Magazine, Most Influential Black Lawyers (2022)
  • Washington DC Super Lawyers, Health Care (2016 to 2020)
  • Cornell University, Sloan Alumni Achievement Award (2020)
  • American Health Law Association, Fellow (2020); Accountable Care Organization Task Force, Vice Chair (2015)
  • Lawyers of Color’s “Nation’s Best,” Inaugural List, (2019)
  • The Legal 500 United States, Healthcare: Health Insurers (2016, 2018)
  • CareFirst Blue Cross Blue Shield, Finance and Investment Committee of Group Hospitalization and Medical Services, Inc., Chair (2016)
  • United Planning Organization, Audit Committee, Chair (2016)
  • Medicaid Health Plans of America, Isadore King Spirit of Service Award (2009)
  • Louis University Health Law Program, Practitioner in Residence (2005)
  • National Association of Health Services Executives, President’s Award (1985)

Appointments

  • Appointed in 2022 as Team Leader of Epstein Becker Green's Health Equity Focused Initiative
  • Appointed in 2021-2023 as a Member of the American Health Law Association Fellows Coordinating Council
  • Appointed in 2021-2022 to the Advisory Committee of the Journal of Health and Life Sciences Law (the official journal of the American Health Law Association)
  • Appointed in 2021 as Co-Chair of Epstein Becker Green’s Minority Attorney Forum
  • Appointed in 2020 as Vice Chair of Epstein Becker Green’s Diversity and Professional Development Committee
  • Elected in 2020 a Fellow of the American Health Law Association
  • Appointed in 2016 as Chair of the Finance and Investment Committee of Group Hospitalization and Medical Services, Inc., d/b/a/ CareFirst Blue Cross Blue Shield
  • Appointed in 2016 as Chair of the Audit Committee for the United Planning Organization
  • Appointed in 2015 as Vice Chair of the Accountable Care Organization Task Force of the American Health Lawyers Association
  • Appointed in 2014 to the Board of Group Hospitalization and Medical Services, Inc., d/b/a/ CareFirst Blue Cross Blue Shield
  • Appointed in 2010 as Co-Chair of Epstein Becker Green’s Health Plan Compliance Group
  • Appointed in 2009 as Chair of the Best Practices and Compliance Committee of the Medicaid Health Plans of America
  • Appointed in 2006 to Epstein Becker Green’s Diversity and Professional Development Committee
  • Appointed in 2005 as Practitioner in Residence at the St. Louis University Health Law Program
  • Appointed in 2004 as Vice-Chair of the Transactional & Business Health Care Interest Group of the American Bar Association
  • Appointed by Tommy G. Thompson, Secretary of Health and Human Services, in 2004 to the State Pharmaceutical Assistance Transition Commission

Credentials

Education

  • University of Virginia (J.D., 1981)
    • Editorial Board, Journal of Natural Resources Law
  • Cornell University (M.B.A., 1974)
    • Hospital Administration
  • Pace University (B.B.A., 1972)

Bar Admissions

Board of Directors

  • CareFirst Blue Cross Blue Shield
  • Medicaid Health Plans of America, Inc.
  • National Association of Health Services Executives

Professional & Community Involvement

  • American Bar Association
  • American Health Law Association: Fellow; Member, Fellows Coordinating Council; Vice Chair, Accountable Care Organization Task Force (former)
  • American Society of Association Executives
  • District of Columbia Bar Association
  • National Bar Association
  • Sigma Pi Phi Fraternity Epsilon Boule'

Events

Past Events

Media

Insights

Insights

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