Andrew B. Wachler

Andrew B. Wachler is the principal and managing partner of Wachler & Associates, P.C., located in Royal Oak, Michigan. With more than four decades of dedicated legal practice, Mr. Wachler is recognized nationally as a preeminent authority in healthcare law. He represents physicians, physician groups, hospitals, ambulatory surgical centers, pharmacies, laboratories, and diverse healthcare organizations across the United States.

Mr. Wachler concentrates his practice on navigating the intricate web of federal and state healthcare regulations. He counsels healthcare clients on complex statutory frameworks, healthcare transactions, internal regulatory compliance programs, and defense against administrative, civil, and criminal enforcement investigations. Throughout his career, he has built a reputation for vigorously defending clients against adverse agency audits and enforcement initiatives.

Case Work and Representative Experience

Mr. Wachler maintains an extensive national practice focusing on defense, appeals, and regulatory problem-solving for healthcare entities. His representative casework includes:

• Medicare, Medicaid, and Commercial Third-Party Payer Audits: Representation of individual practitioners, specialty practices, and health systems in audits administered by Medicare Administrative Contractors (MACs), Unified Program Integrity Contractors (UPICs), Recovery Audit Contractors (RACs), and private commercial insurers.
• Administrative Medicare Appeals: Defense of providers through all five levels of the Medicare audit and recoupment appeal process, including Redetermination, Reconsideration (Qualified Independent Contractors), Administrative Law Judge (ALJ) evidentiary hearings before the Office of Medicare Hearings and Appeals (OMHA), the Medicare Appeals Council, and federal district court judicial review.
• Fraud and Abuse Investigations & Stark Law Guidance: Counseling healthcare organizations on compliance with the federal Stark Law, the Anti-Kickback Statute (AKS), the Civil Monetary Penalties Law, and the federal False Claims Act (FCA). This work includes structuring compliant arrangements, providing regulatory guidance, and resolving government inquires and subpoenas issued by the Department of Health and Human Services Office of Inspector General (HHS-OIG) and the Department of Justice (DOJ).
• HIPAA Privacy and Security Defense: Guiding covered entities and business associates through compliance audits, data breach remediation, risk assessments, and investigations conducted by the HHS Office for Civil Rights (OCR).
• Licensure and Credentialing Matters: Representing physicians and healthcare professionals in state medical board investigations, licensing board actions, hospital peer-review proceedings, and staff privileging disputes.

Honors, Awards, and Accolades

Mr. Wachler is consistently acknowledged by peers and national rating services for his legal acumen and leadership in healthcare jurisprudence:

• The Best Lawyers in America: Listed continuously by U.S. News & World Report / Best Lawyers in the field of Health Care Law.
• Michigan Super Lawyers: Selected as a top-rated healthcare attorney, recognized consistently on the annual Super Lawyers list.
• Top Lawyers in Metro Detroit: Named by DBusiness Magazine as a premier practitioner in health care law.
• Fellow, State Bar of Michigan Health Care Law Section: Conferred into the Class of 2017 Fellows, an honor recognizing career achievements, sustained contributions to the health law bar, and dedication to the profession.

Speaking Engagements and Thought Leadership

Mr. Wachler is an active lecturer and contributor to healthcare law discourse nationwide. He speaks before medical societies, hospital systems, compliance conferences, and professional bar associations on topics including:

• Medicare Appeals and Audit Defense Strategies: Best practices for navigating UPIC and RAC post-payment audit audits, addressing statistical sampling and extrapolation methods, and preparing administrative appeals for ALJ hearings.
• Stark Law and Anti-Kickback Compliance: Structuring physician compensation models, hospital-physician joint ventures, and value-based enterprise arrangements within regulatory safe harbors and exceptions.
• HIPAA/HITECH Compliance and Enforcement: Operational strategies for safeguarding protected health information (PHI), managing ransomware events, and responding to OCR breach inquiries.
• Healthcare Billing, Coding, and Enforcement Trends: Emerging federal scrutiny under the False Claims Act and civil monetary penalty statutes.

In addition to speaking, Mr. Wachler serves on the Editorial Board of The Health Lawyer, the flagship journal of the American Bar Association Health Law Section, specifically overseeing content for the Fraud and Abuse Section.

Professional Leadership and Affiliations

Mr. Wachler actively contributes to national, state, and local bar associations:

• American Bar Association (Health Law Section):
• Current Vice Chair, Health Law and Policy Coordinating Committee
• Editorial Board Member, The Health Lawyer (Fraud and Abuse Section)
• Former Vice Chair, Payment and Reimbursement Interest Group
• Former Vice Chair, Healthcare Policy Task Force
• American Health Lawyers Association (AHLA): Member
• State Bar of Michigan: Member; Member and Fellow, Health Care Law Section
• Oakland County Bar Association: Member
• Medical Group Management Association (MGMA): Member

Education

• Wayne State University Law School — Detroit, Michigan
• Juris Doctor (J.D.), Cum Laude
• University of Michigan — Ann Arbor, Michigan
• Bachelor of General Studies (B.G.S.), Cum Laude
• Recipient, William J. Branstrom Award