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Lance J. Ramsey
Mr. Ramsey is a partner with Gjerset & Lorenz, LLP. Mr. Ramsey has extensive experience representing public, non-profit, and investor-owned hospitals on a broad range of reimbursement issues. He represents numerous hospitals on issues relating to Medicaid and Medicare compliance, rate analysis, and reimbursement appeal matters. A key focal point of Mr. Ramsey’s practice is the development of Medicaid supplemental reimbursement programs, which require the structuring of Medicaid financing mechanisms, such as intergovernmental transfers, certified public expenditures and healthcare-related taxes.
Mr. Ramsey also represents hospitals in disputes relating to payment from managed care plans. Prior to law school, Mr. Ramsey served as a law clerk to the Hon. Harry Lee Hudspeth, Chief Judge, United States District Court for the Western District of Texas.
In the Government Reimbursement area, Lance:
- Advises numerous hospitals on Medicaid Disproportionate Share Hospital (DSH) funding qualification and compliance reporting and appeals.
- Handles Medicaid DSH appeals to ensure state Medicaid agencies accurately include hospital utilization data in making Medicaid DSH awards.
- Develops supplemental Medicaid programs for over 100 hospitals in over 15 communities to obtain federal matching funds for services provided to Medicaid, uninsured, and indigent patients.
- Represents hospitals in Pennsylvania, Texas, New Mexico, Missouri, and Florida in appeals related to Medicaid DSH hospital specific limits before state Medicaid agencies and the Centers for Medicare and Medicaid Services.
- Advises numerous hospitals regarding the government program reimbursement impact of realigning multiple hospital licenses and provider-based status.
In the Administrative Litigation area, Lance:
- Negotiated and implemented innovative partnership agreements between private and public providers on behalf of large non-profit hospital systems.
- Defended large non-profit hospital in Medicaid supplemental reimbursement investigation, reducing potential repayment liability by over $250 million.
- Represented hospitals interest in CMS deferral actions and OIG investigations related to Medicaid supplemental payments.
In the Managed Care dispute area, Lance:
- Served as lead counsel in a lawsuit involving hundreds of claims from 14 hospitals, from an insurer that refused to pay for high cost pass through items.
- Served as lead counsel in a hospital in an arbitration against a large IPA for underpayment of catastrophic stop loss claims.
- Served as lead counsel in two disputed New Mexico Medicaid managed care plans.
- Served as lead counsel in a dispute against a large managed care company that underpaid hundreds of claims. Mr. Ramsey served as trial counsel.
- Served as co-counsel in Georgia case of first impression relating to hospital entitlement to contractual fee schedules even when negotiated rates exceed state fee guidelines.
- University of Texas School of Law, J.D., with honors, 1996
- Associate Editor of The Review of Litigation
- Dean’s Achievement Award for Academic Excellence in Employment Discrimination
- University of North Texas, B.A., 1992
- Austin Bar Association
- American Bar Association
- Austin Young Lawyers Association
- American Health Lawyers Association
- AHLA, Medicaid Supplemental Reimbursements, Institute on Medicare and Medicaid Payment Issues, Baltimore, MD, 2011 and 2012
- HMO Managed Care Law: Health Care Arbitration in Texas - State Bar of Texas - November 7-8, 2002
- Medicaid DSH, UPL and Other Reimbursement Mysteries Reveals, Texas Association for Healthcare Financial Administration, Horseshoe Bay, TX, 2007
- The Changing Medicaid Landscape, Healthcare Financial Management Association, Houston, TX, 2006