Ropes & Gray LLP

Stephen Warnke represents a wide range of health care clients on state and federal regulatory, enforcement and compliance matters. Most recently, he is helping clients navigate a myriad of legal and regulatory issues associated with the response to the COVID-19 pandemic. Stephen’s clients include not-for profit teaching hospitals and medical schools, managed care organizations, investor-owned health care and pharmaceutical companies, and community-based providers of health, mental health and social services.

Stephen advises clients on Medicare, Medicaid and other government funding programs; state and federal fraud and abuse authorities, including the Stark physician self-referral and anti-kickback statutes; the repayment and disclosure obligations that arise from overpayments and improper relationships with referral source physicians; the design and implementation of corporate compliance programs; and the increasingly aggressive use of the state and federal civil false claims statutes by prosecutors and the “qui tam” bar.

A former policy advisor in New York City government, Stephen also counsels clients on New York’s unique regulatory, reimbursement and enforcement landscape and has extensive experience before the New York State Department of Health and other New York regulators. In 2009, at the request of Andrew Cuomo, then New York Attorney General, Stephen became the founding chair of FAIR Health, Inc., a New York charity that publishes the benchmark data used by health insurers to set “usual and customary rates” (or “UCRs”) for out-of-network physician reimbursement. FAIR Health issues independent UCR data for commercial, consumer and academic research purposes and is a major contributor to the health reform debate.