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Iain Stauffer

Of Counsel
t: 919.783.2982

Iain Stauffer represents health care providers with complex civil matters regarding health care reimbursement, Medicaid and Medicare compliance and enrollment, licensing, responses to government investigations, and enforcement actions. He also represents individual practitioners regarding licensing board matters.

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Biography

Iain came to the firm from the North Carolina Attorney General’s Office where he served as an attorney for 12 years, most recently with the Public Assistance Section. In that position, he represented the North Carolina Department of Health and Human Services and the Division of Medical Assistance in complex litigation involving Medicaid in federal and state courts. In addition, Iain also provided advice and counsel in many areas of the Medicaid program, including compliance, program integrity, and managed care. Iain also appeared in numerous actions at the Office of Administrative Hearings involving Medicaid audit, over-payment, reimbursement and authorization matters.

Areas of Focus

+Health Care

Representative Experience

  • As a Special Deputy Attorney General, represented the North Carolina Department of Health and Human Services in multiple Federal Class action lawsuits.
  • Represented the North Carolina Department of Health and Human Services and Division of Medical Assistance in the Office of Administrative Hearings, Superior Court, North Carolina Business Court, and the North Carolina Court of Appeals in matters involving Medicaid, post-payment audits, overpayments, provider enrollment denials and terminations, provider suspension actions, and claims denials.
  • Consulted and advised on complex legal issues regarding the operation of Medicaid programs in a managed care and fee for service structure, including the transition of North Carolina Medicaid to a managed care environment.
  • Participated in numerous reconsideration reviews on behalf of the Division of Medical Assistance on issues including Medicaid overpayments and Medicaid enrollment decisions.
  • Participated in rule-making and drafted administrative rules related to Medicaid and other public assistance programs.
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+Licensure, Credentialing, & Peer Review

  • Represented individual practitioners before various North Carolina licensing boards
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+Regulation, Survey, & Inspection

  • Represented skilled nursing facilities and assisted living facilities with survey and inspection matters
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+Trials, Hearings, & Mediation

  • Represented Medicare providers in multiple levels of Medicare appeals including redetermination, reconsideration, Office of Medicare Hearings and Appeals, and the Medicare Appeals Council
  • Represented health care providers in litigation before the North Carolina Office of Administrative Hearings
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+Administrative Health Care Law

  • Assists clients with review of proposed and permanent North Carolina Administrative rules
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Credentials

+Education

North Carolina Central University School of Law, JD, 2001, magna cum laude

St. John Fisher College, BS, 1994

Editor-in-Chief — North Carolina Central University Law Journal

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+Professional & Community Activities

North Carolina Bar Association, Health Law Section Council Member

10th Judicial District Bar

 

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+Clerkships

Honorable Sidney S. Eagles, Jr., Chief Judge of the North Carolina Court of Appeals, 2001-2003

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