Overview
Colin McCarthy is a healthcare regulatory attorney with more than 15 years of experience advising healthcare providers on compliance, reimbursement, and regulatory matters. Based in Richmond, Virginia, he advises clients nationwide on issues involving Medicare and Medicaid enrollment and reimbursement, licensure, healthcare transactions, and federal and state fraud and abuse laws, including the Stark Law, Anti-Kickback Statute, and False Claims Act.
Colin works with a broad range of healthcare organizations across the care continuum, including hospitals and health systems, ambulatory surgery centers, physician practices, behavioral health providers, home health agencies, hospices, pharmacies, management services organizations, and other healthcare businesses.
“Colin delivers practical solutions while navigating the complexities of our highly regulated field."
--Client Review, BTI Client Service All-Stars 2025
His experience includes advising clients on government audits and reviews, overpayment matters, self-disclosure processes, payer reimbursement disputes, HIPAA and state privacy laws, certificate of need matters, administrative appeals, and internal and external investigations. Colin has represented healthcare providers in matters involving the Centers for Medicare & Medicaid Services, the Office of Inspector General, the U.S. Department of Justice, the U.S. Department of Health and Human Services, the Virginia Department of Health, the Department of Medical Assistance Services, the Virginia Office of the Attorney General, and other state and federal agencies.
In addition to his regulatory practice, Colin maintains an active pro bono practice assisting low-income individuals with insurance coverage and benefit denials.
Representative Matters
Representing providers in reimbursement disputes with Medicare, Medicaid, and commercial insurers
Counseling on state and federal regulatory compliance matters
Development and support of healthcare compliance programs, including internal investigations and counseling on corrective actions
Voluntary refunds, OIG Self-Disclosure Protocol, and CMS Self-Referral Disclosure Protocol submissions
State licensing, Certificate of Public Need (COPN), and other regulatory approvals
Medicare and Medicaid enrollment filings and appeals of revocations, denials, and payment suspensions
Medicare payment status, designation, and reimbursement matters
OIG advisory opinion requests addressing proposed arrangements
HIPAA privacy and security counseling, including policy development, breach response and vendor contracting
Corporate practice of medicine, practice structuring, and healthcare transactions
Recognition & Honors
Honors & Recognitions
Best Lawyers in America, Healthcare, 2026
Virginia’s Legal Elite; Virginia Business Magazine, 2025
BTI Client Service “All-Star,” Healthcare, 2025
CancerLINC, "Rising Star," 2025
Thompson Reuters Stand Out Lawyers, 2024
Virginia Rising Stars, Virginia Super Lawyers, 2018-2020
Pro Bono Honor Roll; Virginia State Bar, 2023
Press & Publications
News
Community & Professional
Associations
Virginia Bar Association; Health Law Section Council, Member, 2025-present
Virginia State Bar; Health Care Section
Legal Information Network for Cancer; Chair, Advocate Board, 2025-present; Pro Bono Attorney, 2015-present
American Health Law Association; Vice Chair, Accreditation, Certification, and Enrollment Affinity Group, 2016-2020
Health Care Compliance Association
Credentials
Education
Christopher Newport University; B.A., 2007
William & Mary Law School; J.D., 2010
Seminars & Presentations
Seminars & Presentations
Speaker, HIPAA and Healthcare Transactions, November 2, 2022
Moderator, “Behavioral Health & Substance Abuse Treatment,” 15th Annual Healthcare Finance and Growth Conference, September 15, 2022
Speaker, “2019 Medicare and Medicaid Year In Review,” AHLA Institute on Medicare and Medicaid Payment Issues, March 25, 2020
Speaker, “Government Enforcement Actions Against Providers,” Healthcare Litigation and Compliance Webinar Series, July 19, 2018
Speaker, “Best Practices for Responding to Medicare Claims Audits and OIG Compliance Audits,” Healthcare Litigation and Compliance Webinar Series, March 22, 2018
Speaker, “Year in Review,” Institute on Medicare and Medicaid Payment Issues, March 2017
Co-presenter, “Provider-Based Status: Recognizing Evolving Compliance Risks and Remembering the Fundamentals,” American Health Lawyers Association Fraud & Compliance Forum, October 2016
Co-presenter, “Developing and Implementing Hospital Capital Projects,” Virginia Hospital & Healthcare Association, March 2016
Co-presenter, “Structuring Healthcare Co-Location Arrangements,” Strafford Webinar, June 2015
Presenter, “Healthcare Regulation,” Virginia Commonwealth University eMBA Program, June 2015
Moderator, “Hospital Co-Location,” American Health Lawyers Association Webinar, May 2015
Co-presenter, “Inpatient or Observation? Practical Advice for Hospitals on Compliance with CMS’ ‘Two Midnight’ Benchmark,” Healthcare Financial Management Association VA/DC Spring Education Conference, March 2014
Co-presenter, “Payer Audit, Enforcement & Compliance: Are You a Target,” Medical Group Management Association Virginia Chapter, December 2013
Co-presenter, “A New Era of Government Enforcement: Strategies for Preparing for and Responding to Government Audits,” Health Care Compliance Association Clinical Practice Compliance Conference, October 2013
Co-presenter, “Avoiding Costly Medicare Enrollment Errors,” Healthcare Financial Management Association VA/DC Summer Conference, August 2011
