ANJALI N.C. DOWNS is a Member of the Firm in the Health Care and Life Sciences practice at Epstein Becker Green. She also serves as the Administrative Member of the Washington, DC, office, where her practice is based. From 2017 to 2019, Ms. Downs was selected to the Washington DC Rising Stars list in the area of Health Care.
Ms. Downs represents a variety of health care and life science organizations including health systems, pharmaceutical and medical device manufacturers, pharmacies, clinical laboratories, academic medical centers, physician group practices, dialysis providers, and medical transportation providers. Her practice focuses on fraud and abuse and federal and state regulatory compliance, and she regularly:
- Defends a variety of health care organizations undergoing government investigations, inquiries, and audits, including behavioral health organizations focusing on mental health and substance use disorders
- Counsels and defends ambulatory surgery centers (ASCs) on a variety of fraud and abuse-related issues
- Counsels behavioral health organizations on various fraud and abuse-related issues, including matters concerning coding and medical necessity
- Conducts internal investigations related to anti-kickback, self-referral, billing and coding, licensure, exclusion, false claims issues, and other regulatory issues
- Assists clients in preparing self-disclosures on a variety of matters
- Serves in the role of an Independent Review Organization, conducting Focus Arrangements Reviews as required under Corporate Integrity Agreements (CIAs)
- Guides clients through implementing and maintaining CIAs
- Advises clients on legal and regulatory compliance matters arising under the Medicare, Medicaid, and other third-party reimbursement programs
- Assists clients in developing, implementing, and evaluating health care compliance programs
- Counsels clients in the areas of federal and state health care fraud and abuse compliance
- Advises clients on physician contracting arrangements and a variety of health care joint ventures
- Assists clients in preparing and submitting advisory opinion requests related to a variety of issues, including ASCs, patient assistance programs (PAPs), and physician-owned distributors (PODs)
While attending the Francis King Carey School of Law at the University of Maryland, Ms. Downs served as a legal intern at the Johns Hopkins Office of General Counsel in Baltimore, MD. She also served as an Articles Editor for the Journal of Health Care Law and Policy.
Prior to law school, Ms. Downs was a member of the adjunct faculties of Georgetown University School of Nursing and Health Studies and Howard Community College in Columbia, MD. She also worked for Georgetown University's Health Education Services Department, where she developed, implemented, and evaluated multi-dimensional, education and health promotion materials.
She is a coauthor of Legal Issues in Health Care Fraud and Abuse: Navigating the Uncertainties, 4th ed., published by the American Health Lawyers Association in June 2012.
- University of Maryland School of Law (J.D., 2008)
- cum laude
- Article Editor, Journal of health Care Law and Policy
- University of Maryland (M.P.H., 2002)
- University of Maryland (B.A., 1999)
- District of Columbia