John R. Hellow has specialized in Medicare and Medicaid payment policy issues since 1982. He has represented hospitals in a wide variety of Medicare and Medicaid payment disputes before federal and state administrative agencies, and has gained extensive experience in advising clients on reimbursement and other regulatory implications of their business transactions. In 1983 Mr. Hellow began representing hospitals in Medicare group appeals and was primarily responsible for representing 700 hospitals in successful challenges to Medicare’s Malpractice Rules and labor/delivery room day policy. He has represented a group of 1400 hospitals in a challenge to Medicare outlier payments.
Mr. Hellow’s current practice has focused on defending providers in Medicare False Claims Act disputes involving cost reporting and anti-kickback related issues. From 1999 until 2003 he was lead regulatory defense counsel in the largest federal health care fraud investigation in U.S. history, where he helped negotiate criminal, civil and administrative settlements of all pending issues with the Centers for Medicare and Medicaid Services and the Department of Justice’s Criminal and Civil Divisions.
Mr. Hellow is lead regulatory payment counsel for some of the country’s leading hospital companies. He is payment counsel to the Federation of American Hospitals where he has primary responsibility for directing industry comments on federal program payment related reform under Medicare and Medicaid, hospital charging practices, including charity care and discounted services and upcoming pay for performance initiatives.
Mr. Hellow has represented hospitals in the United States Courts of Appeals for the District of Columbia, Federal Circuit, Ninth Circuit, Sixth Circuit, Eleventh Circuit and Eighth Circuit, in the United States Court of Federal Claims, and in the United States District Courts for the District of Columbia, Eastern District of Michigan, Western District of Missouri, Central District of California, Northern District of California, Minnesota, Eastern District of Texas, Arizona, Utah and Southern District of Florida, and before the PRRB. Mr. Hellow is an advanced member of the Health Financial Management Association.
Mr. Hellow received his B.A. degree in History and Political Science, with honors from Oakland University in 1977. He received his Masters in Health Care Administration from St. Louis University in 1981 and his J.D., cum laude from Saint Louis University School of Law in January, 1982. Mr. Hellow was the Symposium Editor of the St. Louis University Health Law Review, and Note and Comment Editor of the St. Louis University Law Review during 1980 – 1981.
