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Gabriel T. Scott

Fax +1.919.516.2014

Gabriel Scott is an associate at the firm’s Research Triangle Park office where he practices health law. Mr. Scott applies his prior experience in government, private practice, and healthcare delivery to assist clients in identifying practical legal solutions to complex regulatory issues. His practice focuses on resolving Medicare and Medicare reimbursement issues for hospitals, physicians, and post-acute providers, with an emphasis on:

  • Counseling compliance with the Stark Law and Anti-Kickback Statute
  • Providing guidance on payment and delivery system reform efforts, including rules and regulations created by the Medicare Access and CHIP Reauthorization Act and the CMS Quality Payment Program
  • Analyzing payment and quality issues for providers associated with participation in federal and commercial bundled payment programs and accountable care organizations
  • Advising on telemedicine payment matters

Professional Background

Prior to joining the firm, Mr. Scott served as an associate for a national law firm. He analyzed complex arrangements and provided guidance on Stark Law and Anti-Kickback Statute matters, counseled clients on the development and implementation of innovative health care delivery models and researched and analyzed Medicare and Medicaid reimbursement matters, licensure and enrollment questions, and telehealth payment issues. Prior to entering private practice, Mr. Scott worked for the Centers for Medicare & Medicaid Services (CMS), where his work focused on the development of bundled payment programs, analysis of Stark Law self-referral disclosures, and the design of fraud and abuse waivers for CMS alternative payment models.

Professional/Civic Activities

  • American Bar Association
  • American Health Lawyers Association
  • North Carolina Society of Health Care Attorneys
  • North Carolina Bar Association
  • Tenth Judicial District Bar Association

Speaking Engagements

  • Sharing of Innovative Bundled Payments for Joint Replacement: Bundled Payments for Care Improvement and Comprehensive Care for Joint Replacement, Health Care Payment Learning & Action Network (Aug 17, 2015)
  • Medicare Bundled Payments for Care Improvement Initiative: Experiences on the Front Lines of Alternative Payment, American Health Lawyers Association (May 13, 2015)
  • CMS Makes Changes to MSSP in 2019 Physician Fee Schedule, JD Supra (December 5, 2018)
  • CMS “Goes Fishing” on Stark Law’s Impediments to Value-Based, Coordinated Care, The National Law Review (June 21, 2018)
  • Continuing Resolution Creates Significant Changes to Medicare and Medicaid Policies, The National Law Review (March 21, 2018)
  • Gainsharing Guidance: Clarification on Cost-Savings Arrangements Between Hospitals and Physicians, Austin Medical Times (March 2018)
  • CMS Terminates and Scales Back Mandatory Bundled Payment Models. JD Supra (December 15, 2017)
  • Newly-Announced 340B Payment Rule Presents Financial & Operational Challenges to All Covered Entities, The National Law Review (November 6, 2017)
  • CMMI Requests Ideas to Spur Innovation and Reduce Burden, The National Law Review (October 10, 2017)
  • Hospital Medicare Certification at Risk? CMS Clarifies Inpatient Volume Expectations, The National Law Review (September 26, 2017)
  • Dealing with Disasters – Quality Payment Program Exception Available for MIPS-Participating Clinicians and Groups, The National Law Review (September 21, 2017)
  • CMS Proposal Terminates and Revises Mandatory Bundled Payment Models, The National Law Review (August 18, 2017)
  • MACRA: CMS Proposes Quality Payment Program Updates to Increase Flexibility and Reduce Burdens, American Health Lawyers Association Weekly (July 14, 2017)
  • CMS Initiative For Hip And Knee Replacements Supports Quality And Care Improvements For Medicare Beneficiaries, Health Affairs (Nov 16, 2015)
  • Advised a health system on the creation of a prescription assistance program that complies with federal regulations and OIG guidance.
  • Drafted internal policies and procedures for a specialty pharmacy standardizing the provision of meals and gifts by salespersons to their physician customers.
  • Counseled hospitals on admission to, and participation in, CMS bundled payment models, including gainsharing methodologies and contracting processes.
  • Provided guidance on the acquisition of a physician-owned hospital to ensure compliance with the CMS physician-owned hospital rules and regulations.
  • Developed risk-based physician compensation methodologies for a hospital system that incorporated bundled payment features.
  • Guided a national multi-disciplinary physician group practice through two audits by North Carolina local managing entities to ensure continued participation in the states managed Medicaid program.
  • Analyzed a physician-owned laboratory’s arrangements for Stark and AKS concerns, and directed revisions to laboratory contracts and operations to resolve noncompliance.