Brett Friedman is a health care partner who advises clients at the forefront of the health care industry in areas such as government insurance programs, digital health, accountable care and value-based payments, and regulatory compliance. A former leader of one of the largest Medicaid programs in the country, Brett provides valuable insight and solutions to health care companies and investors navigating complex transactional, regulatory, enforcement and policy matters. Clients rely on Brett not only for his unique experience running a large governmental insurance program, but also his strategic insights into health care investments and deep regulatory knowledge.
Over the course of his career, Brett has held top positions at the New York State Department of Health (NYSDOH), including Director of Strategic Initiatives and Special Medicaid Counsel, and most recently, Deputy Commissioner and State Medicaid Director. While at NYSDOH, Brett oversaw all aspects of New York State’s expansive Medicaid program, which provides health coverage to more than 7.4 million New Yorkers and has an annual operating budget of over $90 billion. He led many innovative efforts during his tenure, including in the areas of Medicaid 1115 research and demonstration waiver programs, value-based care programs, managed care reform, social care integration strategies, and support for investor-backed companies looking to innovate in the governmental payer space.
Brett also has extensive private sector experience. He was a partner at Ropes & Gray before joining NYSDOH, as well as co-head of the firm’s digital health initiative. At the firm, Brett advises payers and providers on the transition to accountable care and value-based payment, and assists investors with a range of transactional needs. Additionally, he counsels clients facing government investigations, audits and self-disclosures, as well as violations of health care fraud and abuse laws.
Brett values pro bono service and has handled many healthcare pro bono matters, including spearheading the legal analysis that was instrumental to the establishment of the first overdose prevention centers in the United States and developing a first-in-the-nation, outcomes-based contract for Medicaid funding of children’s legal advocacy services that remediate a client’s underlying health care issues.
Experience
New York State Department of Health
- Led the development and negotiation of 1115 research and demonstration waivers that allow for the transformation of the state Medicaid program
- Spearheaded the Medicaid program’s payment and regulatory flexibility efforts to ensure provider sustainability during the COVID-19 pandemic, including the unprecedented and rapid expansion of telehealth
- Coordinated the development and strategic design of New York’s updated Value Based Payment Roadmap
- Established the new Center for Medicaid Innovation responsible for cultivating digital health solutions and supporting venture-backed companies looking to enter the Medicaid space
Ropes & Gray
- Developed and negotiated total care of care VBP arrangements with managed care plans for an innovative digital health provider as part of its multistate expansion strategy.
- Led a coordinated federal and state regulatory strategy in connection with the conversion of a digital health company’s pricing model to ensure compliance with federal fraud and abuse and state fee-splitting laws.
- Served as lead health care regulatory counsel in connection with numerous private equity investments in, and recapitalizations of, physician practice management companies, including the creation of one of the nation’s largest practice management platforms through the merger of a prominent multistate urgent care chain with a leading multispecialty group practice.
- Represented a not-for-profit corporation in the successful formation of the first ACO in the New York region, serving primarily individuals with intellectual and developmental disabilities, and the ACO’s subsequent application to participate in the Medicare Shared Savings Program.
- Structured the terms, including associated governance and participation rights, involving a multimillion-dollar strategic investment into a health plan specifically formed to provide coverage to beneficiaries dually eligible for Medicare and Medicaid.
- Represented a client in the successful resolution of a high-profile fraud investigation conducted by the New York State Attorney General and the United States Attorney’s Office for the Southern District of New York into improper billing and cost reporting practices; negotiated one of the first New York State corporate integrity agreements (CIAs) with the Office of Inspector General for the United States Department of Health and Human Services and the New York State Office of the Medicaid Inspector General.
- Represented an academic medical center in the civil resolution of an eight-year investigation into its historical financial relationship with over 20 physician practice groups for compliance with the Stark Law and federal Anti-Kickback Statute.