Overview
Health care organizations, insurers, and life sciences companies turn to attorney Matthew Sprankle for advice and representation in a broad range of health regulatory matters.
His practice focuses on health care fraud, waste, and abuse counseling and defense; government investigations; value-based care contracting, negotiation, and disputes; Medicare Advantage risk adjustment coding and payment; and contracting and commercial disputes. He also provides privacy and cybersecurity compliance advice, general counsel services, and health regulatory counseling.
In particular, Matthew’s services include the following:
- Defending health care and life sciences entities against federal and state government investigations and enforcement actions—including qui tam actions—arising under false claims and false billing laws, such as the False Claims Act, anti-kickback laws, physician self-referral laws, and other state and federal laws, and negotiating settlement agreements and corporate integrity agreements.
- Helping health care entities respond to government and payor audits, including defending Medicare Advantage organizations against and mitigating exposure related to Medicare Advantage audits, such as under the Centers for Medicare & Medicaid Services’ (CMS’s) Risk Assessment Data Validation or by the CMS Office of Inspector General.
- Conducting and facilitating internal investigations, risk assessments, and audits and advising clients on remediation and corrective actions, including policy and operational changes and self-disclosures to the government related to health care fraud and abuse laws.
- Counseling health plans, providers (including risk-bearing providers), and vendors regarding compliance with various Medicare Advantage regulations and agency guidance, including in relation to data and submissions integrity, payment arrangements, coding and medical record documentation guidance, auditing practices, electronic health record management, and organizational controls.
- Advising health plans and providers with structuring, drafting, and negotiating value-based payment arrangements, and providing counsel related to disputes, settlements, and reconciliations.
- Negotiating and drafting contract arrangements on behalf of health care entities engaging vendors that provide wide-ranging products/services, including technology and software, clinical decision support and clinical surveillance, data analytics and data science, care management, and coding and chart review.
- Drafting privacy and security policies, vendor questionnaires, and business associate agreements on behalf of HIPAA-covered entities, business associates, and downstream entities, as well as counseling clients regarding data-breach response.
- Advising clients on compliance with state and federal laws affecting the provision of telehealth and telemedicine services, including issues related to licensure, scope of practice, reimbursement and coverage, and online prescribing.
- Counseling clients on a range of corporate formation, structure, and governance matters.
- Guiding clients through strategic affiliations and transactions, including mergers, acquisitions, joint ventures, and transactional health care regulatory diligence.
Matthew is a contributor to Epstein Becker Green's Health Law Advisor blog and was a longtime contributing author of the firm’s Telemental Health Laws app, a comprehensive survey of state telehealth laws, regulations, and policies for mental and behavioral health practitioners and stakeholders across all 50 states, the District of Columbia, and Puerto Rico. He sits on the firm’s pro bono committee and has served as a mentor and presenter for educating incoming summer associate classes.
Before joining Epstein Becker Green, Matthew was a Teach For America corps member and a seventh- and eighth-grade math teacher in Baltimore, where he worked to provide educational equity to low-income communities.
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Focus Areas
Services
- Corporate & Transactional
- Federal and State False Claims Act (Including Qui Tam)
- Fraud and Abuse Compliance Counseling and Defense
- General Counsel Services
- Government and Commercial Coding, Coverage, and Payment
- Health Care
- Health Care and Life Sciences Investigations and Enforcement
- Managed Care
- Medicare Advantage
- Privacy, Cybersecurity & Data Asset Management
- Telehealth
- Value-Based Purchasing and Accountable Care
Experience
Credentials
Education
- University of Maryland Francis King Carey School of Law (J.D., 2018)
- Health Law Certificate
- Associate Editor, Maryland Law Review
- Johns Hopkins University (M.S., 2015)
- University of Delaware, Alfred Lerner College of Business and Economics (B.S., cum laude, 2013)
Bar Admissions
- District of Columbia
- Maryland
Media
Events
Insights
Insights
- BlogsA Closer Look at Proposed Changes to Medicare Advantage in the “No UPCODE Act”13 minute read
- BlogsCMS’s Final Rule on Medicare Advantage Risk Adjustment Data Validation3 minute read
- Firm AnnouncementsEpstein Becker Green Reports Telemental Health’s Influence Grows Throughout COVID-19 Pandemic6 minute read
- PublicationsCMS Wins on Partial Appeal—D.C. Circuit Court Rules Against United’s Initially Successful Challenge to the Medicare ...13 minute read
- Firm AnnouncementsEpstein Becker Green's Annual Telehealth Analysis Reports an Increase in Telemental Health Fraud6 minute read
- BlogsCongress’s COVID-19 Funding Legislation Expands Access to Telehealth Services for Medicare Beneficiaries6 minute read
- Firm AnnouncementsEpstein Becker Green Finds Telehealth Services Are Increasingly Accessible to Mental Health Professionals Despite ...5 minute read
- BlogsUp in Smoke: The Countdown on Vape Enforcement Discretion Begins8 minute read
- BlogsCMS Seeks to Improve Patient Care and Decrease Costs for Emergency Transportation by Implementing New Medicare Payment ...6 minute read
- PublicationsFDA Proposes to Clarify and Formalize the De Novo Classification Process for Medical Devices1 minute read
- BlogsFDA Proposes to Clarify and Formalize the De Novo Classification Process for Medical Devices7 minute read
- Firm AnnouncementsEpstein Becker Green Finds Increasing Acceptance of Telehealth Services Among Providers and Legislators8 minute read
- PublicationsThe SUPPORT for Patients and Communities Act: Part 1: New Federal Anti-Kickback Law – Eliminating Kickbacks in Recovery ...13 minute read
- PublicationsCMS Final Rule Expands Medicare’s Reimbursement for Physician Services Furnished Using Communication Technology ...11 minute read
- BlogsTop Five Takeaways from MedPAC’s Meeting on Medicare Issues and Policy Developments – November 201811 minute read
- BlogsThe SUPPORT for Patients and Communities Act: President Trump Signs Sweeping Opioid Law2 minute read
- BlogsTop Five Takeaways from MedPAC’s Meeting on Medicare Issues and Policy Developments – October 201811 minute read
- BlogsTop Five Takeaways from MedPAC’s Meeting on Medicare Issues and Policy Developments – September 20189 minute read