Michi Tsuda focuses his practice on operational, regulatory, transactional, and litigation matters in the health care sector. Michi’s clients include hospitals, physician groups, accountable care organizations, management services organizations, private-equity funds, sovereign governments, and health-related joint ventures. He regularly represents private equity clients in the acquisition of health care facilities, with a focus on acute care hospitals, freestanding emergency centers, diagnostic laboratories, and senior care communities, and advises physician practice groups on the organization, sale, and acquisition of physician groups.
Michi also counsels clients on regulatory and compliance matters, including corporate governance, reimbursement, fraud and abuse, and data privacy and security. He routinely drafts compliance program documents, including medical staff bylaws, codes of conduct, and policies and procedures, and represents providers before the Provider Reimbursement Review Board (PRRB), as well as in the Medicare Claims Appeals Process, appealing determinations by Recovery Audit Contractors (RACs), Zone Program Integrity Contractors (ZPICs), and Medicaid Integrity Contractors (MICs).
- Medicare fraud and abuse (Anti-Kickback, False Claims Act, and Stark laws)
- Medicare cost report and claims appeals
- Clinical integration strategies and collaborative care models
- Mergers and acquisitions, joint ventures and strategic affiliations
- Medicare and Medicaid enrollment, participation and compliance
- Domestic and international health care public-private partnerships