Charles C. Dunham, IV

Charles C. Dunham, IV

Shareholder

Charles Dunham represents health care providers and other health-related entities in regulatory compliance, corporate formation and governance, business transactions and acquisitions, and commercial arrangements. He also advises private-equity firms and venture capitalists on investment in the health care industry and health regulatory due diligence reviews of target acquisitions and negotiated transaction documents.

Charles represents a variety of health care clients, including:

  • Clinical laboratories and pathology groups
  • Telehealth providers and management companies
  • Hospitals and health systems
  • Physician group practices and networks
  • Ambulatory surgery and infusion centers
  • Post-acute and long-term care providers
  • Health information technology companies

Charles has a depth of experience in fraud and abuse counseling and defense matters, involving the federal Anti-Kickback Statute (AKS), the Physician Self-Referral Law (Stark Law), the False Claims Act (FCA), the Eliminating Kickbacks in Recovery Act (EKRA) and analogous state fraud and abuse laws. He applies this knowledge to advise clients on legal risks and structuring compliant ownership, financial and referral arrangements that are consistent with their business goals.

Charles represents his clients in government investigations and whistleblower (qui tam) actions; government and accreditation organization surveys and sanctions; and commercial payor audits and investigations (SIUs), and unilateral recoupment actions. He also advises on provider participation and enrollment, network and managed care contracting, billing and coding, reimbursement and collections and overpayments, including medical necessity determinations and collection of patient responsibility.

Charles works with a range of health care organizations to develop and implement strong compliance programs and training programs to educate directors, officers and employees. That includes counseling on federal and state health regulatory compliance; conducting internal compliance reviews and risk audits; developing and implementing corrective action strategies; developing compliance manual and control protocols; and performing training and education programs.

Charles takes a professional interest in understanding a client’s business and operations to better counsel and meet the particular legal needs of his client. He is adept at client management and endeavors to set realistic cost estimates and time frames for his clients to receive a quality work product.

Concentrations

  • False claims
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Capabilities

Experience

  • Outside general counsel to multiple clinical, pathology, genetic, and other specialty laboratories advising on CLIA and state laboratory rules and enforcement, regulatory compliance matters, lab-to-lab referrals and reference lab arrangements, and government and commercial payor reimbursement policies.°
  • Represented multiple hospitals throughout the country in the sale of all or segments of their outreach laboratory programs and joint venture arrangements with independent laboratories.°
  • Represented multiple laboratories in defending against CMS-imposed principal sanctions to suspend CLIA certificate and cancel Medicare payments.°
  • Counseled numerous laboratories on compliance with Medicare regulatory and compliance issues, including CMS Medicare Part B collection and reporting requirements under PAMA Section 216.°
  • Counseled numerous laboratories on compliance with the Eliminating Kickbacks in Recovery Act (EKRA) and structuring compensation and billing arrangements
  • Counseled biobank and cord blood banking organizations on federal and state health regulatory compliance and business initiatives.°
  • Outside general counsel to numerous telehealth practice groups and management companies advising on federal and state regulatory matters related to state licensure and standard of practice, corporate practice of medicine (CPOM) laws, remote prescribing rules, government and commercial payor reimbursement, and HIPAA and state privacy and security laws.°
  • Counseled multiple physician practices offering a blend of telemedicine and concierge services in multiple states on corporate formation, foreign registration and regulatory compliance with federal and state laws.°
  • Represented a variety of health care providers and suppliers in appealing Medicare and Medicaid exclusion, revocation, and deactivation of billing privileges and implementing changes to corporate and regulatory compliance protocol.°
  • Represented a physician group practice in a joint venture with an integrated health system under a mission support arrangement for hospitalist and outpatient specialty physician services.°
  • Represented an accountable care organization on corporate governance issues, provider participation arrangements, and the implementation of an integrated CMS compliance plan.°

°The above representations were handled by Mr. Dunham prior to his joining Greenberg Traurig, LLP.

Recognition & Leadership

  • Super Lawyers Magazine
    • Selected, Super Lawyers New York Metro Rising Stars, 2016-2018
    • Selected, Super Lawyers Upstate New York Rising Stars, 2015
  • Member, Clinical Laboratory Management Association (CLMA), 2018-Present
    • Member, Legislative, Compliance and Regulatory Committee, 2018-Present
  • Member, American Health Lawyers Association, 2016-Present
  • Member, Houston Bar Association, 2016-Present
    • Member, Health Law Section, 2016-Present
  • Member, American Bar Association, 2015-Present
    • Member, Health Section
  • Member, New York State Bar Association, 2009-Present
    • Member, Health Law Section, 2010-Present
    • Co-Chair, E-Health & Information System Committee, 2014-2017

Credentials

Education
  • J.D., cum laude, Albany Law School
    • Health Law Concentration
    • Senior Editor, Albany Law Review
  • B.A., magna cum laude, State University of New York at Albany
Admissions
  • New York
  • Texas
  • U.S. District Court for the Northern District of New York
  • U.S. District Court for the Southern District of New York
  • U.S. District Court for the Western District of New York
  • U.S. District Court for the Southern District of Texas