Anil Shankar, Esq., is a partner and health care lawyer with Foley & Lardner LLP, and a member of the Health Care Practice. He provides strategic counsel to health care providers as they navigate complex regulatory and reimbursement matters, with a particular focus on the Medicaid program and issues affecting safety net providers.
Shankar advises hospitals, clinics, health systems, managed care plans, and governmental entities on their participation in Medicaid programs. He has helped develop innovative new programs, including Medicaid supplemental payments, quality networks, state and local provider taxes or assessments, and public-private partnerships.
Shankar is a leading expert in the use of health care funding to address the social determinants of health and helped design and implement California’s Whole Person Care pilots, which operate innovative programs for vulnerable populations.
Shankar advises clients on numerous Medicaid reimbursement and compliance issues, including overpayment investigations and analyses. He has also assisted numerous companies seeking to enter the Medicaid program. Shankar has deep knowledge of Medicaid managed care and has helped plans and providers evaluate regulatory changes and structure alternative payment methodologies to meet their goals. He also heads the firm’s robust 340B Drug Pricing Program Practice.
Shankar has extensive experience advising clients on behavioral health reimbursement, operational, and compliance issues. He counseled hospital and health systems seeking to expand their behavioral health offerings, including strategic counseling to avoid licensing, regulatory, and reimbursement pitfalls. In addition, he helped design systems to protect and share confidential patient information, including behavioral health information.
Shankar has successfully obtained millions of dollars of funding for providers and mental health delivery systems through administrative appeals. He works with local behavioral health directors, providers, and managed delivery systems on issues related to funding, reimbursement, program development, and strategic implementation.
Throughout the COVID-19 pandemic, Shankar advised hospitals, health systems, governmental entities, nursing facilities, and other health care companies with regards to their application, receipt, and use of federal relief funds, including the Provider Relief Fund and Coronavirus Relief Fund. He has advised on the development of tracking and documentation systems, counseled providers on over- and underpayments of funds, and drafted policies and procedures for use and reporting of funds.