Troy Barsky

Troy Barsky is a Partner in King & Spalding's Healthcare practice in the Washington, D.C. and Denver offices, where he focuses on healthcare fraud and abuse, Medicare and Medicaid law and policy, and state oversight of healthcare. Troy counsels all types of healthcare entities, including hospitals, technology companies, device manufacturers, and life sciences companies on the physician self-referral law (Stark Law) and the Anti-Kickback Statute; innovative healthcare delivery models, such as Accountable Care Organizations (ACOs); and Medicare and Medicaid payment and coverage policy.

Troy also represents various healthcare entities in the regulatory aspects of healthcare transactions, including compliance, corporate structuring, diligence, licensure, and credentialing. He also conducts internal investigations and defends clients in government enforcement actions by the U.S. Department of Justice, U.S. Health and Human Services Office of the Inspector General, the Centers for Medicare & Medicaid Services (CMS), and state enforcement agencies. Finally, Troy works with clients to develop public policy and regulatory solutions for clients advocating to state and federal regulators.

Troy has extensive healthcare government experience, serving at the U.S. Department of Health and Human Services (HHS) for 11 years, from 2002 to 2013. Troy was the director of the Division of Technical Payment Policy at CMS from 2009 to 2013, where he was responsible for Stark Law policy and other Medicare payment issues. He implemented important sections of the Affordable Care Act, including the creation, development, and operation of the CMS Voluntary Self-Referral Disclosure Protocol (SRDP). Troy was also a key team member in developing the Medicare Shared Savings Program and Medicare ACOs, including the issuance of fraud and abuse waivers associated with this program. Additionally, he advised the Center for Medicare and Medicaid Innovation (CMMI) in the development and testing of new demonstrations and models. Troy also wrote and issued Stark advisory opinions; developed Medicare technical payment policy in areas such as the timely filing of Medicare claims, and assignment and reassignment; and reviewed waiver requests by hospitals to move from their designated Organ Procurement Organization (OPO).

Prior to joining CMS, Troy served in the HHS Office of the General Counsel, CMS Division, Program Integrity Group from 2002 to 2009. In that role, he focused on Medicare and Medicaid fraud and abuse. Specifically, Troy was the program integrity senior litigation attorney, where he focused on pharmaceutical and medical device False Claims Act matters. Additionally, Troy gained high-level experience regarding the collection of Medicare overpayments. Troy represented CMS in administrative matters before the HHS Departmental Appeals Board regarding Medicaid taxes and donations and intergovernmental transfers. He also extensively advised CMS on Medicare and Medicaid payment policy.

Troy is ranked Band 1 by Chambers USA.