Richie Lopez is an Associate in the firm's Healthcare practice group. He works with clients to develop compliance policies and procedures; investigate, disclose, and resolve compliance concerns; prepare and respond to government audits and investigations; and challenge government audit findings through the administrative appeals process. Richie’s attention to detail and grasp of complex reimbursement and regulatory issues provides clients with clarity in the face of regulatory challenges and risks.
Richie’s experience includes Medicare/ Medicaid, HIPAA, 340B, and state licensure compliance issues, as well as challenging audit findings, including by HHS-OIG, HRSA, OCR, UPICs, and ZPICs. He has also successfully represented healthcare providers in commercial and medical staff disputes, and assisted in responding to potential data breaches. With his finger on the pulse of healthcare developments, Richie keeps his clients abreast of regulatory and legal changes that impact their businesses.
Richie is certified in Healthcare Compliance (CHC) by the HCCA Compliance Certification Board.
Advise health systems, physician groups and business associates with HIPAA privacy and security issues, including developing policies and procedures.
Assist healthcare providers and other entities with preparing for and implementing new policies in response to information blocking regulations.
Support efforts in investigating and responding to potential HIPAA data breaches, as well as OCR patient access investigations.
Represent providers (hospitals, physicians, home health agencies, hospices, and skilled nursing facilities) in Medicare and Medicaid contractor audits (including UPIC, ZPIC, and RAC) and appeals, including experience in successfully reversing statistical extrapolations.
Represent hospital systems in assessing compliance with 340B program requirements and responding to HRSA audits and investigations.
Advise hospitals, physician groups, SNFs and other providers with regulatory matters, including compliance issues, investigations and voluntary refunds to government payers (Medicare, Medicaid, and Tricare).
Represented hospital seeking Georgia CON approval for multi-specialty ASC and cancer center offering radiation therapy services.
Supported in representation of coalition of healthcare providers challenging multi-million dollar attempts by Medicare Administrative Contractor to recoup alleged overpayments.
Assisted in successfully resolving qui tam action against hospital alleging violation of False Claims Act relating to emergency medical services.
Represent several tenants in actions against landlords involving uninhabiltilty and security deposit issues through participation in the Atlanta Volunteer Lawyers Foundation Saturday Lawyers Program. Through his efforts, Richie has secured the return of improperly withheld security deposits, as well as reimbursement for diminished value of rent and damaged personal property.
Presenter, "Health Insurance Portability and Accountability Act (HIPAA)," July Membership Meeting and Monthly CLE, The Florida Government Bar Association (July 2021)
Panelist, "Emerging Issues in Social Risks," ESG and Compliance Conference, Society of Corporate Compliance and Ethics (June 2021)
Presenter, "Legal Trends in Healthcare," Georgia Association Medical Staff Services Virtual Conference (March 2021)
Author, "Georgia, USA," The Meritas US & Canada Cannabis Guide, pgs 37-39 (January 2021)
Moderator, “Business as (Not) Usual: General Counsel on Business During Coronavirus” (June 2020)
Panelist, "Networking through Bar Service" - March Group Mentoring Program, State Bar of Georgia (March 2020)
Author, "340B Covered Entities Under the Microscope: Major Changes to the 340B Drug Discount Program Are Underway" – AHLA RAP Sheet, Vol. 20 Issue 3 (December 2017)
Author, "CMS Request for Information Regarding Implementation of MIPS, Promotion of APMs, and Incentive Payments for Participation in Eligible APMs" - Alert - AHLA Physician Organization & Regulation, Accreditation, and Payment Practice Groups (October 2015)