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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

Northern Long-Eared Bat Granted Federal Endangered Status

Alerts

USFWS Proposes Revision to African Elephant 4(d) Rule

Alerts

Red Flags That a Company May Be in Financial Trouble, Part 2

Alerts

NYS Governor Hochul Signs Bill Requiring Posting of Veterans' Benefits and Services

Alerts

Office of Cannabis Management Preview of NYS Adult-Use Cannabis Regulations

Alerts

Moving Defendant Relying on a Complete Defense Need Not Disprove Every Exception

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