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BradGallagher

Counsel

"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 counsels pharmacies nationwide relating to their relationships with pharmacy benefit managers (PBMs) and other vendors, helping them in disputes relating to network participation rights, audits, and network terminations. He also assists in fraud, waste, and abuse investigations by PBMs and government agencies.

Brad uses his knowledge of the pharmaceutical marketplace and negotiation skills to save clients from being put out of business as the result of recoupments or network terminations, helping them to collectively save millions and continue serving their communities. He has obtained injunctions against PBMs on behalf of pharmacies to stave off terminations or illegal withholds, and has also represented physicians who have been victims of identity theft, wherein their credentials have been stolen and used to process fraudulent claims. Brad has successfully negotiated their reinstatement into provider networks and aided them in clearing their reputations of wrongdoing.

An experienced litigator, Brad represents pharmacies, physicians, wholesalers, and other health care organizations in complex disputes. He has a successful record of delivering favorable and cost-effective results through direct negotiations, alternative dispute resolution, and litigation in state and federal courts nationwide.

In addition, Brad assists entrepreneurial clients with the development and formation of entities, including group purchasing organizations (GPOs), charitable foundations, claims processors, and other innovative business models.

Bar Associations

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

Representative Experience

Health Care

  • Represents national and local pharmacies in negotiating removals of negative findings and reductions in audit findings by PBMs and the Office of the Medicaid Inspector General.
  • Obtained injunctions and court orders against PBMs prohibiting networks terminations and illegal withholds.
  • Drafted and developed policies and procedures for pharmacies, GPOs, and claims processors.
  • Assisted pharmacies in gaining access to pharmacy networks.
  • Obtained reinstatements into networks after being terminated for alleged fraud for physicians who had been victims of medical identify theft.
  • Defended an assisted-living residence 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 multiple complaints alleging dental malpractice against the facilities and the dentists providing care.
  • Developed and drafted policies and procedures for network and internal compliance programs.
  • Assisted in the development and formation of health care-related entities.

Commercial/Other

  • Represented owners and contractors in single- and multi-party litigation relating to construction and design defects as well as construction accidents requiring the review and evaluation of contracts (including risk-transfer provisions), insurance procurement documents, building material specifications, building and industrial codes, site inspection for workmanship issues and retention, and work with architects, engineers, and cost-estimators.
  • Represented clients in catastrophic injury and mass-tort litigation in cases involving industrial and commercial machinery, asbestos-containing products, mold, exterior insulation and finishing systems, and food and beverages.
  • Represented clients in single trauma and occupational exposure actions, property damage, and contract and indemnity disputes. Developed and implemented litigation and response strategy based on client needs, often relating to time-sensitive and mass media-covered events for national transportation providers.
  • Represented corporate entities in claims against group self-insurance trusts and insurance brokers.

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 Member

Featured Media

Alerts

New NYS Hemp Legislation Signed

Alerts

NY Green Bank and NY PSC: Energy Storage Updates

Alerts

House Judiciary Committee Advances MORE Act

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