For more than a decade, health care clients have turned to attorney David Johnston for creative, practical solutions to their legal problems. David regularly counsels clients on a wide range of reimbursement issues, including Medicare cost report issues and appeals and provider-based compliance and opportunities.

He also guides clients on all aspects of 340B drug program compliance and management, pharmacy compliance and operations, provider and supplier enrollment and enforcement issues and appeals, change of ownership transactions and implementation, and long-term care transactions and certificates of need.

His clients include hospitals, health systems, pharmacies, Federally Qualified Health Centers (FQHCs), Rural Health Centers, long-term care providers, and numerous other types of health care facilities. In addition, home health and behavioral health providers and durable medical equipment companies seek David’s advice on optimizing their compliance and operations.

Focus Areas


  • Represented a home health agency in its successful appeal of post-Medicare change of ownership request for anticipated payment (RAP) suspension imposed by the Centers for Medicare & Medicaid Services (CMS), which was worth $15 million to the agency.
  • Represented a health system in its sale of a skilled nursing facility to the management firm of the nursing facility. David formulated potential structures, drafted and negotiated various agreements, and implemented each agreement’s operation. The sale involved a bed purchase agreement, Medicare change of ownership, certificate of need, and comprehensive facility and operating lease, as well as several regulatory filings.
  • Provided 24/7 support to a health system responding to the COVID-19 pandemic, advising it on federal and state regulations, including waivers issued as a result of the public health emergency declaration. David also advised on staffing, compensation, quality, and patient care issues, as well as expanding telehealth abilities and related reimbursement issues. Additionally, he counseled the health system on vaccination rollout and reimbursement issues.
  • Currently represents a variety of behavioral health providers in state licensure matters as well as general operational and compliance matters.
  • Drafted and negotiated a pharmacy services agreement and 340B contract pharmacy agreements on behalf of a hospital system with national pharmacy providers.
  • Managed and successfully negotiated multiple self-disclosures by 340B covered entities to multiple drug manufacturers and the Health Resources Services Administration (HRSA).
  • Currently represents 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.
  • Served as lead counsel in the acquisition of a nonprofit health system by a health corporation, negotiating the transaction, drafting all corporate documents, conducting due diligence review, and completing all regulatory filings.
  • Prepared successful provider-based and mid-build attestations for a hospital system regarding an off-campus, provider-based department, and counseled the client through the process.
  • Currently represents hospitals and health systems in provider-based, space-sharing, and co-location compliance issues and Medicare Administrative Contractor repayments.


  • Ohio Rising Stars, Heath Care (2009 to 2010, 2012 to 2013, 2019)
  • Listed in The Best Lawyers in America©, Health Care Law (2024)



  • University of Texas School of Law (J.D., with honors, 2006)
    • Associate Articles Editor, Texas Journal of Business Law
  • Davidson College (B.A., magna cum laude, 2001)
    • Phi Beta Kappa

Bar Admissions

Court Admissions

Professional & Community Involvement

  • American Health Law Association
  • Columbus Bar Association
  • Healthcare Finance and Management Association, Central Ohio Chapter
  • Society of Ohio Healthcare Attorneys




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