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BradGallagher

Partner

"In practice, I view the resolution of an issue as not having a singular impact, but acting as a means to achieve broader results."

Overview

Biography

Brad concentrates his national practice on providing legal services to clients in the pharmaceutical industry, including independent retail, chain, specialty, and compounding pharmacies. Brad represents wholesalers, manufacturers, technology companies, and others with legal, regulatory, and compliance issues in the pharmacy space. He also represents other health care providers, including physicians, laboratories, and durable medical equipment (DME) providers.

Brad counsels clients nationwide on issues with health plans, pharmacy benefit managers (PBMs), and government entities such as credentialing and enrollment, audits and investigations, network terminations, and reimbursement disputes. Specifically, Brad has assisted providers in overturning enrollment denials and with the recovery of millions of dollars for providers following challenges to audit findings or improper reimbursements. Brad also counsels clients in matters pertaining to contract management, best practices, and other business-related issues, with a focus on those entities operating in the pharmaceutical industry.   

Brad represents entities in pharmacy- and other health care-related transactions, including those involving entities, chains, or private equity. Brad also assists entities with corporate formation, due diligence, licensing, and credentialing. 

Bar Associations

  • New York State Bar Association, Reimbursement, Enforcement, and Compliance Committee Member
Experience

Representative Experience

  • Assisted pharmacies with PBM and the NYS Office of the Medicaid Inspector General (OMIG) various types of audits and investigations.
  • Successfully recovered tens of millions of dollars on behalf of pharmacy clients and other health care providers in improper recoupments and chargebacks.
  • Negotiated settlements of fee dispute and claims reimbursement issues, including generic effective rate (GER), on behalf of pharmacies and other providers.
  • Obtained injunctions and orders against PBMs prohibiting networks’ terminations and illegal withholds.
  • Developed best practices and compliance policies for clients and providing guidance on internal self-audits and corrective action plans (CAP).
  • Assisted providers with licensing, network enrollment, and credentialing.
  • Lead a health care transactional team in purchasing and sales of pharmacies, DME providers, and other health care entities nationwide. The team has successfully completed sales ranging from small into the high eight figures to individuals, corporations, chains, and private equity.  
  • Assist entrepreneurs, innovators, and start-ups with navigating the health care compliance and regulatory risks in the pharmaceutical marketplace.
  • Defended an assisted living residence (ALR) against allegations that it operated as an unlicensed residential health care facility and nursing home in violation of state and federal laws. Obtained a favorable settlement among the multiple plaintiffs, insurance companies, and co-defendants.
  • Obtained dismissals of complaints alleging dental malpractice against the facilities and the dentists providing care.

Prior Experience

  • Landman Corsi Ballaine & Ford P.C., Of Counsel
  • US District Court for the Northern District of New York to Magistrate Judge George Lowe, Intern

Judicial Clerkships

  • Superior Court of New Jersey, Judge Stuart Peim

Selected Community Activities

  • City of Saratoga Springs, Zoning Board of Appeals, Vice Chair
Knowledge

Selected Speaking Engagements

  • Pharmacists Society of the State of New York, Inc. Annual Convention, "Hacked! – Securing Your Pharmacy Data and Handling the Breach"
  • Northwest Pharmacy Convention, "Hacked! – Securing Your Pharmacy Data and Handling the Breach"
  • National Association of Specialty Pharmacy, Lunch With a Lawyer, "PBM Audits Gone Awry: Avoid Adverse Results by Successfully Preparing for and Responding to Audits"
  • Community Clinic Association of Los Angeles County, "340B Program: Update on Drug Manufacturer Notices and Action Plan"

Selected Publications & Media

Selected Alerts & Blog Posts

Featured Media

Alerts

Third Circuit Ruling Recognizes Due Process Claim in Favor of Drug Distributors Subjected to Quasi-Governmental Credentialing Standards

Alerts

CPLR Article 52 Is Exclusive Vehicle to Challenge Use of Enforcement Procedures

Alerts

HHS OCR Issues Guidance on the Use of Remote Communication Technologies for Audio-Only Telehealth Services

Alerts

ADA Accessibility Lawsuits: Appellate Court Affirms Dismissal of Braille Gift Card Complaints

Alerts

Subchapter Five Debt Limit Update: What Was Down Is Heading Back Up!

Alerts

President Biden Uses Production Defense Act Authority to Suspend Tariffs on Solar Imports From China and Other Countries Amid Ongoing Commerce Probe

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