Practice Concentration and Experience:
Michael Cook is a Partner and Co-chair of the Health Care Group at Liles Parker PLLC and has represented health care related clients full-time for more than 41 years. Before that, for the initial 7 ½ years of his career, he represented the Medicare, Medicaid, and AFDC (now TANF) programs as an attorney with the Office of General Counsel for the United States Department of Health and Human Services and its predecessor, the United States Department of Health, Education and Welfare (“HHS”). During this period, Michael handled a number of major issues and cases, many of which were of the highest legal complexity and political sensitivity. For example, in the process of representing the government in a major series of cases, Michael conducted an internal investigation of a senior government official, and which served as a case study at the Harvard School of Government. Michael was also involved in a number of cases in Federal Court, several of which ultimately were decided by the Supreme Court. During this period, he also served on detail as a Special Assistant United States Attorney in the Northern District of Illinois.
Michael left the government in 1981 to join the Washington, DC office of Wood, Lucksinger & Epstein, which at the time was one of the early and premier health law boutiques. Since then, Michael has been a partner in, and headed the DC health care practices for, several major national and international law firms and currently serves as a Partner and Co-chair of the Health Law Group at Liles Parker PLLC.
Over the past 42 years, Michael has represented numerous clients small and large on a variety of matters involving litigation, business, fraud and abuse and compliance, coding and coverage, reimbursement, certificate of need, other regulatory and public policy matters. He has represented clients before numerous state and federal agencies. He has done this on behalf of individual providers, groups of providers, manufacturers, suppliers, and trade associations.
During his career, Michael has both published and lectured extensively to groups of health care professionals and attorneys, including the AHLA. Michael also has served on the Editorial Board for the AHLA’s Journal of Health and Life Sciences Law from 2008 - 2019 and has published a number of articles in various trade journals and publications, including the Journal, and been a contributing author for a number of books.
In addition to his law practice, Michael has served as a Strategic Healthcare Advisor to ImpactWear International LLP, a start-up company that had developed an innovative product to reduce hip fractures in the elderly. He has served as a guest lecturer at the Erickson School of Senior Living, American University School of Law, Johns Hopkins Bloomberg School of Public Health, George Washington University School of Public Health, Temple University, Shenandoah University, and the Administrative Law Review.
In addition, Michael has lectured extensively to a variety of industry groups, such as the American Health Lawyers Association, the Healthcare Financial Management Association, the Cavendish Global Health Care Initiative, the American Health Care Association, Leading Age, the National Subacute Care Association, Argentum, the American Hospital Association, the American College of Health Care Administrators, the American Medical Directors Association, the National Association for the Support of Long Term Care, and Morgan Stanley addressing topics such as:
- coverage and payment for new technologies under the public programs
- the Affordable Care Act and its implementation, including delivery system reform
- opportunities for home health agencies and skilled nursing facilities under Alternative Payment Methodologies such as the Comprehensive Joint Replacement program
- internal investigations
- subacute care
- government audits and suspension
- RAC audits
- the Medicare Part D program
- managed care contracting for nursing facilities
- complying with the privacy rules and implementing HIPAA requirements to protect health information
- integrating post-acute services in the continuum of care
- contracts and other joint ventures between hospitals and long-term care companies
- integrated networks and managed care contracting for post-acute services
- institutional reimbursement disputes under the Medicaid program
- discrimination by payer source in access to long-term care services
- diversification for long-term care facilities
- survey and certification disputes
- fraud and abuse and corporate compliance programs
- the Nursing Home Reform provisions of the Omnibus Budget Reconciliation Act of 1987
- Medicare routine-cost limits
- regulatory issues for assisted living facilities
Michael has contributed articles on significant issues to leading medical industry trade publications. He currently serves on the Editorial Board of the Journal of Health and Life Science Law, a publication of the American Health Lawyers Association.
- Counsel to hospital on major issues of Medicaid audits similar to Medicare RAC audits
- Providing counsel to companies seeking Medicare coverage and reimbursement for new products
- Counsel to large home health agency on an audit by the Office of the Inspector General
- Advised skilled nursing facility company on the settlement of an investigation by the United States Department of Justice over therapy services
- Representing companies before the Office of Inspector General in the voluntary disclosure process
- Provide strategic advice for company with new technology and product on markets and opportunities in the market and with respect to delivery system reform
- Obtaining successful decision for home care company threatened with the loss of its license
- Successfully obtaining settlement to reverse decision terminating privileges for dentist under the Medicaid program
- Conducted internal investigation for health care company
- Successful resolution of Medicare dispute for LTACH
- Regulatory counsel for private equity group in $370 million acquisition of assisted living facilities
- Numerous Medicare reimbursement disputes and audits, including a recovery for a major publicly traded company that owns and operates CCRCs of in excess of $2 million in a Medicare payment dispute over home healthcare services, and settlements resulting in excess of $1-2 million for a variety of disputes under the Medicare routine cost limits for skilled nursing facilities.
- Special counsel for the acquirers of a chain of nursing facilities for over $1 billion.
- Obtained retroactive adjustment to the wage index for a group of hospitals through Medicare IPPS rulemaking press.
- Regulatory counsel in a $260 million acquisition of group homes and ICF/MRS located in numerous states.
- Regulatory counsel for $500 million acquisition of assisted and independent living properties.
- Counsel or special counsel to companies in investigations involving the provision of home health services, nursing facilities, and DSH funding.
- Negotiated exemption of transferred nursing facilities from corporate integrity agreement
- Assisted in the development of corporate compliance programs for two chains of nursing facilities.
- Assisted publicly traded company in the business of senior housing, CCRCs, and assisted living in complying with HIPAA privacy requirements.
- Counsel in numerous licensing, survey, and certification disputes and issues in numerous states and federal regions for nursing facilities, hospice programs, and assisted living facilities.
- Counsel in numerous Medicaid payment disputes and audits in a variety of states, including disputes under the former Boren Amendment.
- Successful legislative relief exempting county healthcare complex from classification as an institution for mental diseases.
- Represented skilled nursing facility in audit of therapy services by the Office of the Inspector General.
- Involved in the development of one of the first skilled nursing facilities in the country to deliver care to ventilator-dependent residents under the Medicaid program, including the development of special enhanced payment rates.
- Represented landlord, debtor and creditors committee, in various nursing-home and hospital bankruptcies.
Community Service and Affiliations:
In his community service endeavors, Michael is currently serving on the Boards of Directors of First Star, Inc. (national charity that partners with Universities to establish programs for hard to place foster children) and the Blue Ridge Medical Center (a Federally Qualified Health Center that provides primary care to a medically underserved rural community in Central Virginia), and has previously served on the Executive Committee of the Center for Public Service and Scholarship at Shenandoah University and the Boards of the National Osteoporosis Foundation, the Political Science Department of Temple University, and the Democratic Business Council of Northern Virginia. He has counseled on a volunteer basis the campaigns of candidates for national and statewide public office on health care issues, including serving on a work group on health care policy and delivery system reform for the 2016 campaign of Hillary Clinton for President, has served on the Health Care Transition Teams for Governors McAuliffe and Kaine, and on the Long-Term Care Work Group of Governor Kaine’s Health Reform Commission.
More recently, Michael advised on a volunteer basis the campaign of Governor Ralph Northam of Virginia on health care issues, as well as advising the Democratic candidates for the House of Delegates in Virginia on stabilizing the health care insurance market and served on the Health and Human Resources Policy Council for the transition of Governor-Elect Northam. He was appointed by Governor McAuliffe and reappointed by Governor Northam, to, and until March 2023, served as Chair of, the Virginia Board of Medical Assistance Services that oversees and advises Virginia’s Medicaid program. Michael also served as a volunteer on the health care policy team of the campaign of “Mayor Pete” Buttigieg for the Democratic nomination for President, as a Biden-Harris volunteer on health policy in their campaign for President and Vice President, and as a volunteer advisor on health care for the 2021 campaign of Terry McAuliffe for Governor of Virginia.
Michael is a Fellow of the American Health Lawyers Association, has been included for many years in Who’s Who in American Law, Who’s Who in America, Who’s Who in the World, and Who’s Who in the East, and has received the Albert Nelson Marquis Lifetime Achievement Award by Marquis Who’s Who. Michael has an AV rating by Martindale and an AVVO rating of 10.0 – the highest ratings possible from those organizations.
- Villanova University School of Law, Philadelphia, Pennsylvania (J.D., 1973)
- Temple University, Philadelphia, Pennsylvania (B.A. cum laude, 1969)
- District of Columbia Bar Association
- American Health Lawyers Association
- Pennsylvania Bar Association
- American Bar Association
- Admitted to Practice in the District of Columbia & Pennsylvania