Michael Bassham Email & Phone Number

Nashville, Tennessee, United States

Greater Nashville Area, Tn

Providing assistance and guidance to individuals and to entities of all sizes in the area of healthcare law, administrative law, regulatory compliance, contracts, bid protests and procurements, including proposals submitted to private and governmental entities.

Greater Nashville Area, Tn

TennCare, the Tennessee Medicaid program, has 1.5 million lives and an annual budget of approximately $11.5 billion. As General Counsel, I provide legal services to all parts of the program for all functions - managed care contracting, procurement, provider relations, long term services and supports, legislative review and drafting, program integrity and litigation oversight. My work can be grouped into three areas - regulatory compliance, contracts and litigation oversight. As the federal health care regulatory structure is being remade, every part of TennCare leadership looks to me for legal counsel on the ways the agency can maintain compliance, within the available resources. Because TennCare is 100% managed care, nearly every aspect of the program is dependent on contractors to effectuate its goals. Thus, I have extensive experience helping to craft RFPs and the contracts that go with them. Once an award has been made, my work shifts to contract compliance and, when necessary, amendment or termination. TennCare is and has been a defendant in a number of civil rights class actions and state court lawsuits. The Attorney General’s Office and an outside law firm represent the agency in these matters. I work closely with outside counsel to respond to the allegations and preserve and gather discovery material. Throughout the process, I make certain that the leadership team is knowledgable about the status of the litigation and any developments on the horizon.Administratively, I am responsible for a staff of 48 professionals. Together, we solve problems and help our clients achieve their goals while understanding the relevant legal requirements, restrictions and opportunities.

Oversight of all federal litigation involving the Division of Health Care Finance and Administration (HCFA). HCFA is made up of The Bureau of TennCare, the Office of eHealth Initiatives, State Health Planning, Health Insurance Exchange and the Cover Tennessee programs (CoverTN, AccessTN, CoverRx, CoverKids). Also, oversight of the Privacy and Public Records Office and the development of the legal aspects of anti-fraud efforts. Responsible for ethics compliance.

Although I work in the Antitrust Division, I handle civil prosecutions of health care fraud cases involving TennCare providers and other false claims act cases. I have more experience with the Tennessee Medicaid False Claims Act, T.C.A. sec 71-5-181, et seq., and the Tennessee False Claims Act, T.C.A. 4-18-101, et seq., than anyone else. The health care fraud cases I have handled include those involving pharmaceutical manufacturers and distributors, hospitals, radiology clinics, durable medical equipment suppliers, nursing homes and many others.

General practice with a focus on insurance defense litigation, including medical malpractice.

J.D., Law

B.A., Political Science