Stephen Bittinger is a partner in the firm's Charleston and Washington, DC offices. He is a member of the health care/FDA practice group. Stephen focuses his practice on health care reimbursement compliance, defense and litigation, with an emphasis on government and private payer disputes on behalf of providers, suppliers, and manufacturers involved in the U.S. health care system nationally and from abroad. He has extensive experience representing large provider groups, home health agencies, medical facilities, ancillary service providers, medical labs, revenue cycle management companies, and drug and device manufacturers in matters including Medicare and Medicaid audits, private payer audits, federal regulatory termination and exclusion proceedings, False Claims Act defense, and health care revenue disputes. Stephen is one of the leading attorneys in the country on the law regarding the use of statistical sampling and extrapolation in the review and analysis of health care claims. He has served as an expert witness regarding federal reimbursement law in civil and criminal proceedings. Stephen has represented many providers with federal agency matters, including the Centers for Medicare and Medicaid Services (CMS) Center for Program Integrity (CPI), the Department of Health and Human Services Office of Inspector General (HHS-OIG), the Department of Veteran Affairs (VA), and Health Care Fraud division of the Department of Justice (DOJ).
Prior to joining the firm Stephen served at a regional commercial law firm where he focused his practice on health care reimbursement defense and litigation. Previously, Stephen and team represented numerous types of physician practices, home health agencies, medical facilities, ancillary service providers, medical laboratories, revenue cycle management companies, and drug/device manufacturers in Medicare audits (RAC, ZPIC, UPIC, TPE), Medicaid audits (SIU), private payors audits, federal regulatory termination, and exclusion litigation related to the health care revenue cycle.
- Listed, The Best Lawyers in America®, Health Care Law, 2024
- Stephen Bittinger was named “Presenter of the Year” by 1st Healthcare Compliance
- Charleston Business Magazine's Legal Elite – Health Care, 2022 and 2023
- Presenter, “OIG, FCA, & RADV: The Rising Risk of Medicare Advantage,” Cozeva, 18 October 2023
- Panelist, “Hunting Health Care Fraud Post-Pandemic: Audits and Investigations,” Charleston Health Care Summit, 13 October 2023
- Panelist, "Hunting Pandemic Fraud: Audits and FCA Litigation Resulting
From the PHE," 2023 Physicians Legal Issues: Healthcare Delivery & Innovation Conference, 7 September 2023 - Panelist, "The Current State of RA Litigation and Risk Areas for MA Plans, Physician Groups, Vendors and Downstream Entities," RISE West 2023, 29 August 2023
- Panelist, "Legal Challenges to Extrapolated Overpayments from RADV Audits," Rise 21st Risk Adjustment Forum, 10 May 2023
- Presenter, Risk Adjustment Innovations, "Staying Compliant as Regulatory Activity Increases for Risk Adjustment: CMS RADV Regulations, OIG Audits, and DOJ Lawsuits," 18 April 2023
- Speaker, MedtradeEAST, "Understanding How the Government Uses Audits to Bring Fraud Investigations," 24 October 2022
- Speaker, Homecare and Hospice Conference and Expo, "Legal Challenges to Statistical Sampling & Extrapolated Overpayments," October 2022
- Speaker, RISE West 2022, "The Current State of RA Litigation and Risk Areas for MA Plans, Vendors and Downstream Entities," 1 September 2022
- Speaker, Risk Adjustment Compliance – Best Practices For Avoiding Legal Action, 9 November 2021
- Speaker, RISE West 2021, "Legal Insights Panel: Trends in Audit and Compliance Issues," 2 September 2021
- Speaker, Virtual Regional Healthcare Compliance Conference: "Big Data and False Claims Act Risk Due to COVID-19," Health Care Compliance Association, 6 August 2021
- "Due Process: A Winning Weapon Against Extrapolated Overpayments," American Health Law Association, 11 April 2024
- "DOJ Indicts Former Executive at Medicare Advantage Organization, Signaling Continued Commitment to Individual Accountability in Corporate Criminal Investigations," American Health Law Association, 16 November 2023
- "Righting an Institutional Wrong: Redefining an Overpayment Through HHS-OIG's Policy Shift on Zero-Paid Claims," American Health Law Association, 11 August 2023
- "False Claims Act Enforcement Involving Medicare Advantage Plans: Recent Cases and Current Trends," American Health Law Association, 18 May 2023
- "Statistical Sampling and Extrapolation," American Bar Association, 28 December 2022
- "The Hunt is On: OIG Targets Telehealth Fraud During the COVID-19 Pandemic," American Bar Association, 31 October 2022
- "Medicare Reimbursement Audit Checklist," LexisNexis Practical Guidance, October 2022
- "Weekly News and Compliance Strategies on Federal Regulations, Enforcement Actions and Audits," Report on Medicare Compliance, Vol. 31 No. 32, 5 September 2022
- “Hunting Telehealth Fraud Under COVID-19 Waivers and Expansion,” Pratt’s Government Contracting Law Report, December 2021
- "Qui Tam Quarterly: COVID-19 and the Big-Data Revolution of False Claims Act Legislation," Health Law Journal- Vol. 26 No. 2, New York Bar Association, 25 May 2021
- Quoted, "As ‘Originator’ of Codes for HCCs, Providers Face Their Own Risk From Crackdown on MA Plans," Report on Medicare Compliance, 30 October 2023
- Quoted, "Medicare Advantage insurers will score $2 billion gift thanks to limited audits," STAT+, 1 February 2023
- Quoted, "All OIG Claim Denials From a Vent Audit Are Overturned; OIG National Audit Is Underway," Report on Medicare Compliance, 30 January 2023
- Interviewed, "In ‘Dual Audit,’ Lab Is Audited by Both I-MEDIC and MA Plan’s SIU," Health Care Compliance Association, 31(27),1 August 2022
- Quoted, "Medtrade West Delivers On In-Person Promise," HomeCareMag.com, 2 August 2021
- Quoted, "Rulings: Sampling, Extrapolations Should Include Underpayments, Unpaid Claims," Report on Medicare Compliance, 12 July 2021
- Quoted, "More RAC Audits Are Coming, This Time From VA for Community Care," Health Care Compliance Association, 10 May 2021
- Quoted, "Report on Medicare Compliance: Commercial Player, Medicare Telehealth Audits are Underway, with Some Surprises," Health Care Compliance Association, 18 January 2021
