Ronald S. Connelly

Ron Connelly is a principal in Powers Pyles Sutter & Verville's healthcare and litigation practices.

Ron represents acute care hospitals, rehabilitation facilities, academic medical centers, physicians, and other providers on a variety of healthcare matters, with a particular focus on litigation related to Medicare and Medicaid reimbursement.

From his early career as a financial analyst for academic medical centers, Ron developed an appreciation for the critical services that hospitals provide, and a unique understanding of the complexity of reimbursement-related issues.

Ron has extensive experience litigating large dollar specialty payments, such as Medicare graduate medical education, and is a leader of the firm’s practice representing providers in audits and appeals of Medicare coverage determinations, including denials resulting from audits by Recovery Audit Contractors, Zone Program Integrity Contractors, and Medicare Administrative Contractors. He has also challenged disproportionate share hospital payments and the Medicare wage index. Ron has represented clients in district courts and courts of appeal, before the Provider Reimbursement Review Board with respect to hospital cost report appeals, and before administrative law judges on matters related to individual claim appeals.

Ron is an annual presenter at the American Medical Rehabilitation Providers Association, and he has spoken on topics including Medicare audits and Provider Reimbursement Review Board procedures before the American Health Lawyers Association, He also has appeared before the American Academy of Physical Medicine and Rehabilitation and has been published by HFM Magazine, the publication of the Healthcare Financial Management Association.

Additionally, Ron has:

• Won an important case in the Eighth Circuit Court of Appeals that will protect access to 340B-discounted drugs in Arkansas and potentially many other states
• Won an significant federal court case for several teaching hospitals that will result in significant Medicare repayments to those hospitals in 2021.
• Negotiated nationwide global settlement of Medicare inpatient rehabilitation claims in 2019.
• Represented University of Chicago Medical Center, the Henry Ford Health System, and University of California San Diego Medical Center before the federal courts of appeal.
• Served as co-leader of the firm’s Audit and Appeals Group, which has assisted clients with thousands of Medicare appeals since 2008.
• Served as legal counsel to the FAIR (Fund for Access to Inpatient Rehabilitation) Fund, which raises awareness of, and builds support for, policies that will preserve and increase access to inpatient rehabilitation.
• Represented an individual Medicare beneficiary – a retiree on a fixed income – who required airlift services from a remote part of the country to an urban hospital with the expertise to treat his condition.