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Mark is a Partner in the firm’s Healthcare practice and Co-Chairs the firm’s Life Sciences and Healthcare Industry Group, which is comprised of more than 300 lawyers across the firm. As the former HHS Deputy Associate General Counsel for Litigation for the Centers for Medicare & Medicaid Services, Mark has over 20 years of experience in Medicare reimbursement policy and Medicare fraud defense and represents numerous health care systems and hospitals in navigating the Medicare regulatory environment. Mark has served as the lead litigator on numerous Medicare reimbursement litigation cases defending providers against government enforcement actions, and frequently advises clients on Medicare reimbursement strategy and regulatory and compliance requirements.
For more than 20 years, Mark has counseled clients in navigating through the complex realm of Medicare, a regulatory environment so intricate that the Supreme Court has described it as “unintelligible to the uninitiated.” In that vein, Mark specializes in representing clients and litigating complicated Medicare reimbursement issues, including the successful challenge to Medicare’s so-called “Two Midnight” 0.2 percent rate cut. As a former high-ranking litigator within the Department of Health and Human Services, Mark brings credibility and an insider’s knowledge when advocating before the Centers for Medicare & Medicaid Services and Congress on Medicare and Medicaid issues.
Drawing upon his experience as CMS’s former chief litigation counsel, Mark represents hundreds of hospitals in Medicare reimbursement appeals. His cases typically challenge national Medicare reimbursement policies, with hundreds of millions of dollars at stake. On the defense side, Mark’s years of government fraud enforcement experience and Medicare knowledge translates to surgically effective representation of providers in Medicare fraud investigations.
Mark is more than just a litigator. According to Chambers USA, sources praise Mark’s ability to “distill issues carefully and thoughtfully,” while also praising his “very client service-oriented” approach. Given Mark’s vast knowledge of the pitfalls and complexities woven throughout the regulatory and compliance labyrinth of Medicare and Medicaid, Mark is able to counsel and strategize with clients on diverse topics such as Graduate Medical Education reimbursement for teaching hospitals, Medicare’s “provider-based” rules, and Medicare coverage standards for inpatient services.
His extensive and lengthy experience in handling complex Medicare and Medicaid issues has led Mark to be deemed a nationally-recognized expert, particularly on matters related to Medicare reimbursement. Mark is also a frequent speaker and a Faculty Member of the Institute on Medicare and Medicaid Payment, and participates annually in the Institute’s conference sponsored by the American Health Lawyers’ Association. Mark is also co-editor of the Reimbursement Advisor, a leading publication within the healthcare finance community.
J.D., Harvard Law School, cum laude
B.A. Political Science, University of Dayton, summa cum laude
California
District of Columbia
Maryland
Supreme Court of the United States
U.S. Court of Appeals for the D.C. Circuit
U.S. Court of Appeals for the Ninth Circuit
Law Clerk, Pierce Lively, U.S. Court of Appeals for the Sixth Circuit
June 17, 2022
Mark Polston discusses the Supreme Court case involving the HHS over 340B program discounts
June 8, 2022
Legal 500 United States 2022 Recognizes King & Spalding Practices and Lawyers Among the Top in the Nation
June 1, 2022
Chambers USA 2022 Recognizes 188 K&S Lawyers and 75 K&S Practice Groups as Leaders in Their Fields
"Represented over 200 hospitals in a successful lawsuit challenging CMS's decision to cut inpatient Medicare hospital rates to offset the financial impact of the so-called Two Midnight rule, leading to a reversal of the policy by CMS and an influx of approximately $660 million in additional Medicare reimbursement to the nation's acute care hospitals."
"Won an $18 million arbitration award for a national healthcare company involving breach of contract and fraud claims against sellers of a Medicare-reimbursed hospice."
"Spearheaded the RAC Coalition, a group of the nation's leading hospitals which successfully lobbied for reform of the Medicare Recovery Audit Contractor program."
See more
February 2, 2021
Key Insights from Leaders on the Status of Vaccine Distribution
January 31, 2021
Telehealth Beyond the Public Health Emergency- How the delivery of remote care may change after Covid-19
April 14, 2020
CARES Act: Public Health and Social Services Emergency Fund
June 17, 2022
Mark Polston discusses the Supreme Court case involving the HHS over 340B program discounts
June 8, 2022
Legal 500 United States 2022 Recognizes King & Spalding Practices and Lawyers Among the Top in the Nation
June 1, 2022
Chambers USA 2022 Recognizes 188 K&S Lawyers and 75 K&S Practice Groups as Leaders in Their Fields
"Represented over 200 hospitals in a successful lawsuit challenging CMS's decision to cut inpatient Medicare hospital rates to offset the financial impact of the so-called Two Midnight rule, leading to a reversal of the policy by CMS and an influx of approximately $660 million in additional Medicare reimbursement to the nation's acute care hospitals."
"Won an $18 million arbitration award for a national healthcare company involving breach of contract and fraud claims against sellers of a Medicare-reimbursed hospice."
"Spearheaded the RAC Coalition, a group of the nation's leading hospitals which successfully lobbied for reform of the Medicare Recovery Audit Contractor program."
See more
February 2, 2021
Key Insights from Leaders on the Status of Vaccine Distribution
January 31, 2021
Telehealth Beyond the Public Health Emergency- How the delivery of remote care may change after Covid-19
April 14, 2020
CARES Act: Public Health and Social Services Emergency Fund
June 17, 2022
Mark Polston discusses the Supreme Court case involving the HHS over 340B program discounts
June 8, 2022
Legal 500 United States 2022 Recognizes King & Spalding Practices and Lawyers Among the Top in the Nation
June 1, 2022
Chambers USA 2022 Recognizes 188 K&S Lawyers and 75 K&S Practice Groups as Leaders in Their Fields
J.D., Harvard Law School, cum laude
B.A. Political Science, University of Dayton, summa cum laude
California
District of Columbia
Maryland
Supreme Court of the United States
U.S. Court of Appeals for the D.C. Circuit
U.S. Court of Appeals for the Ninth Circuit
Law Clerk, Pierce Lively, U.S. Court of Appeals for the Sixth Circuit