B. Scott McBride

Partner

Houston
T 713.646.1390  |  F 713.751.1717

"Scott McBride handles a range of investigations and reviews for healthcare providers, and is held in high regard by peers for his impressive expertise in this area."

— Chambers USA 2013

Scott McBride concentrates his practice on providing legal services to the healthcare industry with an emphasis on compliance and enforcement issues, including representing and advising hospitals, academic medical centers, physician groups, and other healthcare clients. He represents and advises clients in overpayment disputes, False Claims Act litigation, internal and external investigations, and regulatory enforcement proceedings, including matters related to Medicare and Medicaid billing compliance, Civil Monetary Penalties, Stark and anti-kickback laws, corporate oversight, and exclusions from federal and state healthcare programs. He also counsels clients in comprehensive corporate compliance matters, including assisting and advising clients on internal investigations, self-disclosures, and repayment matters.

Scott advises clients on Medicare, Medicaid, and other government reimbursement and coverage matters. He represents clients in certain business transactions and financial arrangements, and also represents clients in healthcare matters before state and federal agencies and through administrative appeals, including claims appeals of Recovery Audit Contractors (RAC), Zone Program Integrity Contractors (ZPIC), and other Medicare and Medicaid contractors and payors. Scott also represents clients in payment disputes and recovery activities involving commercial payors.

Select Experience

  • Representation of hospitals, physician groups, and other institutions in enforcement actions by the Department of Justice, the Office of Inspector General, and state Attorney General's Office in investigations related to Medicare and Medicaid billing compliance, including DRG coding, E&M coding, prohibited referrals, cost reports, medical devices, and other false claims allegations.
  • Representation of hospitals and physician groups in self-disclosures and repayment issues made to the Office of Inspector General and to Medicare and Medicaid carriers, intermediaries, and payors.
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Experience

  • Representation of hospitals, physician groups, and other institutions in enforcement actions by the Department of Justice, the Office of Inspector General, and state Attorney General's Office in investigations related to Medicare and Medicaid billing compliance, including DRG coding, E&M coding, prohibited referrals, cost reports, medical devices, and other false claims allegations.
  • Representation of hospitals and physician groups in self-disclosures and repayment issues made to the Office of Inspector General and to Medicare and Medicaid carriers, intermediaries, and payors.
  • Representation of healthcare providers in administrative appeal of overpayment demands from Program Safeguard Contractors and other Medicare contractors.
  • Representation of dental group providers before Medicaid agency and in administrative appeal related to overpayment allegations and demands.
  • Assisted various healthcare entities in the implementation and operation of corporate compliance plans, including risk assessments, internal reviews, and voluntary disclosures and repayment matters.
  • Assisted in the representation of a group of hospitals in national Laboratory Unbundling initiative resulting in the government withdrawing the investigation in Texas.
  • Representation of hospital and physicians in payment disputes with commercial insurance payors related to underpayments to the provider, as well as overpayment demands from the payor.
  • Representation of hospitals, physician groups, and other providers in administrative appeals on issues related to disproportionate share payments, licensing, teaching physician billing, graduate medical education, clinical laboratory rules, and EMTALA.
  • Representation of physician groups and hospitals in transactional and financial arrangements, including joint ventures, residency programs, billing services, physician recruitment, professional services and other contracted services, and reimbursement issues.
  • Representation of physician group in administrative appeal of overpayment demand related to teaching physician billing issues.
  • Representation of hospitals in administrative appeal related to residency programs, direct graduate medical education, and indirect graduate medical education issues.

Recognitions

  • McBride, B. ScottChambers USA: Healthcare in Texas (2013, 2014)
  • The Best Lawyers in America© (2008 to 2015)
    Copyright 2013 by Woodward/White, Inc., of Aiken, SC
      • Houston: Healthcare Law
          • Best Lawyers® 2015 "Lawyer of the Year"
  • Texas "Super Lawyer" (2010 to 2014)
    • Among Top 100 Super Lawyers in Texas (2013) 
    • Among Top 100 Super Lawyers in the Houston area (2010, 2012, and 2013)
    • Texas Super Lawyers "Rising Star" (2004 to 2010)
  • "Outstanding Fraud and Compliance Lawyer" Nightingale's Healthcare News (2005 and 2009)

Memberships

  • American Bar Association
  • State Bar of Texas
  • Health Care Compliance Association
  • American Health Lawyers Association: Member
  • Healthcare Financial Management Association: Member
    • Texas Gulf Coast Chapter: Past President (2006 to 2007)

Services

Industries

Admissions

  • U.S. Court of Appeals, First Circuit
  • U.S. Court of Appeals, Fifth Circuit
  • U.S. District Court, Northern District of Texas
  • U.S. District Court, Southern District of Texas
  • U.S. District Court, Western District of Texas
  • Texas, 1997

Education

  • J.D., Brigham Young University Law School, 1997; magna cum laude; Order of the Coif; Managing Editor, Brigham Young University Law Review
  • B.S., Brigham Young University, 1994, cum laude