Sheree R. Kanner
Sheree Kanner brings a wealth of experience to health clients from her years serving as the general counsel for the Centers for Medicare & Medicaid Services (CMS), where she was involved in almost every major legal issue facing the agency, including Medicare and Medicaid reimbursement and coverage, fraud and abuse, HIPAA, and managed care.
Sheree's government experience enables her to advocate on behalf of clients that want a policy, regulation, or statute changed or need to respond to audit or enforcement findings. She understands how CMS operates and how to approach the agency and others in the Department of Health and Human Services (HHS). Sheree has succeeded in getting CMS to change Medicare rules governing hospitals, issue guidance to states on coverage of products under Medicaid and change audit findings to allow a provider to remain in the Medicare program, as well as to recover millions of dollars in Medicare payments for clients.
She has successfully litigated CMS violations of the notice and comment requirements of the Administrative Procedure Act in establishing Medicare payment rules, HHS’s failure to provide timely Medicare administrative appeals, CMS’s application of a Medicare Advantage rule to an insurer, CMS’s refusal to designate a hospital as a Critical Access Hospital, CMS’s promulgation of a Medicaid payment limit, and numerous other cases.
Sheree has drafted compelling comment letters and regularly meets with agency staff and senior officials in an effort to change or reverse CMS policies and proposals. And if those efforts fail, Sheree goes to Capitol Hill to try to get Congress to take action for her clients. She works collaboratively with those both in and outside the government to achieve her clients' goals.
Areas of Focus
Got CMS to change the Medicare rules governing hospitals that are exempt from the Medicare inpatient prospective payment system.
Successfully sued to get a hospital designated as a Critical Access hospital.
Got a federal court to say that CMS had violated the APA by failing to provide adequate notice and opportunity for comment on a proposed rule.
Got CMS to withdraw proposed quality measures.
Got CMS to issue guidance to a state regarding what had to be covered under Medicaid.
Got CMS to reverse a multi-million dollar disallowance from a Medicare cost report.
Helped convince the Department of Justice to decline to intervene in a Medicare qui tam.
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