Rachel Gilbert is a partner in the firm’s Healthcare practice and specializes in providing hospital systems with strategic reimbursement advice and advocacy. Rachel’s experience includes designing and implementing new supplemental Medicaid payment programs, optimizing participation in existing Medicaid and Medicare programs, advising on federal and state compliance issues, and litigating payer-provider disputes with health plans across products.

Rachel’s legal practice focuses on advising hospitals in reimbursement, regulatory, legislative, and operational business matters. 

In the Medicaid space, Rachel works on behalf of her clients in collaboration with industry and government stakeholders to design, implement, and finance Medicaid supplemental reimbursement programs. Rachel represents investor-owned, non-profit, and governmental hospitals, ranging from large acute care systems, freestanding children’s hospitals, and freestanding psychiatric hospitals. In addition to advocating for new or improved payment programs, Rachel works with hospitals to optimize their participation in existing reimbursement programs within dozens of states, including Medicaid Disproportionate Share Hospital programs, waiver programs, and state directed payment programs.

Rachel also represents hospitals in complex payment and contract disputes. Rachel has represented numerous providers in disputes with Medicare Advantage plans and Medicaid managed care organizations, on issues ranging from underpayments, overpayments, denials, slow-pays, and compliance with federal and state regulatory requirements. Rachel has also represented providers under investigation by state and federal agencies for issues ranging from False Claims Act violations, violation of the federal IMD exclusion, and other billing and reimbursement related audits and allegations. 

Rachel enjoys partnering with clients to compliantly develop and implement hospital financial strategies. Rachel is well-versed in various forms of advocacy for her clients, such as developing talking points for C-suite executives, drafting proposed laws and regulations, performing complex financial modeling in support of client proposals, and facilitating industry coalitions to advocate for improved access to reimbursement before state and federal lawmakers.

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