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Bobby R. Sanders
Bobby Sanders is an associate with Gjerset & Lorenz, LLP, where his practice centers on advising hospitals and physician practices in attaining their Medicaid reimbursement objectives. Mr. Sanders’ in-depth knowledge of Medicaid reimbursement methodologies, compliance considerations, and state budget structures enables him to provide tailored legal advice and business solutions to the hospital community in an ever-changing environment. In Mr. Sanders’ practice, he has:
- Advised hospitals and physician practices regarding their participation in all phases of Medicaid supplemental payment programs, including identifying available state and local funding sources, quantifying the financial impact of interrelated revenue streams on state and federal payment caps, projecting the effect of operational changes on qualification and funding determinations, and assessing post-payment audit risk.
- Counseled hospitals in many states regarding their involvement in the Medicaid Disproportionate Share Hospital (DSH) program, including the interplay between federally mandated qualification standards and state-specific qualification thresholds, the projected impact of the Medicaid DSH allotment reductions under the Affordable Care Act, the relationship between Medicare cost reporting and uncompensated care cost calculations, and the development of reporting protocols in light of evolving federal and state administrative policies.
- Performed regulatory and financial due diligence for various transactions, including academic affiliations, joint ventures, management arrangements, hospital acquisitions, and consolidations, to ensure compliance and viability of existing sources of Medicaid revenue and to identify and implement post-transaction opportunities.
- Advised numerous physician practices regarding their participation in Medicaid fee-for-service and managed care payment programs, including the interaction between Upper Payment Limits and the expansion of Medicaid managed care, federal and state rules related to the calculation of Medicare rates and average commercial rates as the ceiling on payments, and the financial and regulatory impact of strategic alignments between safety-net hospitals and physician practices.
- Analyzed federal and state regulatory and policy proposals and developed strategies and advocacy materials related to Medicaid Graduate Medical Education payment methodologies, Medicaid DSH qualification and funding calculations, preprints for state-directed Medicaid managed care programs authorized under 42 C.F.R. § 438.6, and healthcare-related taxes structured in accordance with Title XIX of the Social Security Act.
- University of Southern California Gould School of Law, J.D., 2016
- President, Health Law Society
- California Polytechnic State University, San Luis Obispo, B.S., 2013
- Member, Administrative Law Section of the Austin Bar Association
- Member, Administrative Law and Health Law Sections of the State Bar of Texas