James A. Robertson

Bar Admissions

• New Jersey, 1990
• Pennsylvania, 1990
• U.S. District Court, District of New Jersey, 1990
• U.S. Court of Appeals, Third Circuit, 1997
• U.S. Supreme Court, 2001

Representative Matters

• The firm’s team represented a coalition of New Jersey hospitals in a $300 million constitutional challenge to the State of New Jersey’s charity care and Medicaid reimbursement regime, defending the hospitals’ takings claims through summary judgment, Appellate Division review, and New Jersey Supreme Court proceedings, resulting in published decisions affirming dismissal of the claims. The hospitals filed a petition for certiorari with the Supreme Court of the United States, which was denied.
• Represented a New Jersey healthcare system and its Chair of Surgery in litigation brought by a trauma surgeon challenging a summary suspension of medical staff privileges. Following reinstatement through internal proceedings, the firm continued to defend the client in this $2.4 million action, which settled before trial.
• Representing 170 hospitals nationwide before the Medicare PRRB in challenges to CMS’ historical calculation of IPPS rates dating to federal fiscal year 1986. The matter, valued in the hundreds of millions of dollars, seeks correction of longstanding reimbursement underpayments and remains pending before the PRRB.
• Representing over 300 hospitals nationwide in Medicare PRRB and federal court litigation challenging CMS’ application of the rural floor budget neutrality factor affecting federal fiscal year 2024 wage indices. The firm’s team secured expedited judicial review and filed suit in the U.S. District Court for the District of Columbia seeking declaratory relief and damages.
• Representing 173 hospitals nationwide in Medicare PRRB proceedings challenging CMS’ exclusion of Section 401 hospital wage data from rural floor reimbursement calculations. This Medicare reimbursement matter, valued in the hundreds of millions of dollars, remains pending before the PRRB.
• Representing a New Jersey healthcare system and its leadership in litigation arising from termination of a surgeon’s staff privileges, defending claims for alleged wrongful suspension and lost income.
• Advised a medical practice in a Chapter 11 bankruptcy proceeding involving competing claims from a private equity sponsor, an acquisition lender, and the practice’s physician owners. The matter addressed disputes arising from the dissolution of the practice, restrictive covenant issues, and claims exceeding $35 million. The firm guided the parties to a global settlement and confirmation of a Chapter 11 plan of liquidation, resolving all claims.
• Represented a New Jersey healthcare system in defense of antitrust and tort claims brought by a pediatric surgeon following revocation of privileges, securing a negotiated resolution.
• Represented a New Jersey healthcare system in defense of fraud, breach of contract, age discrimination, and CEPA retaliation claims brought by three physicians and their surgical group seeking more than $9 million.
• Represented a leading senior care provider in dozens of guardianship proceedings for residents lacking family decision-makers, coordinating with the New Jersey Office of the Public Guardian to secure medical authority and Medicaid eligibility.
• Represented a real estate company as healthcare and regulatory counsel in developing assisted living facilities in Scotch Plains, East Brunswick, and Old Tappan in transactions exceeding $10 million.
• Representing two New Jersey health systems in high-stakes litigation against multiple Medicare Advantage plans seeking recovery of approximately $5 million in underpaid 340B drug reimbursements, following a U.S. Supreme Court decision invalidating CMS' reimbursement reductions; matters are proceeding toward mediation and arbitration.
• Advising a local government agency on the formation of a compliant “friendly P.C.” structure for the operation of New Jersey’s largest psychiatric hospital, including drafting and negotiating all transactional and governance documents.
• Advising a ABA therapy organization in responding to a New Jersey MFD audit. This matter includes counseling the client on the MFD interview process, assisting in providing relevant documentation responsive to the audit, and advising the client on compliance with follow-up requests from the MFD in anticipation of an eventual resolution of the audit, including any repayment demands.
• Represented a client in a New Jersey Appellate Division appeal arising from Medicaid reimbursement and eligibility determinations, authoring the appellate brief and securing affirmance of the agency’s decision.
• Represented a defendant in a New Jersey Superior Court matter, securing dismissal of claims based on the Entire Controversy Doctrine in a published Law Division decision.

Memberships

• Healthcare Financial Management Association, New Jersey Chapter: Chair, Communications Committee; Editor, Garden State FOCUS Magazine
• American Health Law Association: Hospitals and Health Systems Practice Group

Announcements