David O. Ault

Dave is a partner in the firm’s Healthcare practice, where he advises clients on value-based care, Medicare regulatory and reimbursement matters, CMS program participation, and healthcare contracting. He draws on nearly a decade of service at the U.S. Department of Health and Human Services, where he held leadership roles in the Office of the General Counsel (“OGC”) and the Centers for Medicare & Medicaid Services (“CMS”). He helps accountable care organizations (“ACOs”), management services organizations (“MSOs”), health systems, providers, medical device companies, and other industry participants navigate federal healthcare requirements and turn them into practical business strategies.

At OGC, Dave was a seasoned litigator who advised CMS on complex Medicare reimbursement policy. He later served as Director of the Division of Financial Risk at CMS’s Center for Medicare and Medicaid Innovation (“CMMI”). There, he led the development and implementation of several CMMI payment and care-delivery models and value-based care programs. This experience gives him an insider’s view of how federal healthcare programs are designed, run, and enforced. He brings that view to his work guiding clients through the regulatory, operational, and financial sides of Medicare and value-based care.

Value-based care is a central focus of Dave’s practice. He counsels clients on value-based arrangements across government and commercial payors, including agreements among ACOs, MSOs, providers, and other participants in value-based care models. Because he regularly works with these arrangements, Dave brings both a regulatory and market viewpoint. He helps clients assess whether proposed terms reflect prevailing market practices, identify provisions that may warrant additional negotiation, evaluate and manage regulatory risk — including compliance with Stark, Anti-Kickback Statute, and beneficiary inducement laws — and understand how individual arrangements fit within broader cross-market value-based contracting strategies.

Dave also advises healthcare organizations on Medicare program participation, regulatory compliance, organizational and operational structures, reimbursement, and contracting. He drafts and negotiates agreements with providers and other participants, helps clients prepare for and respond to Medicare audits, and addresses reimbursement disputes and other matters involving CMS. He also advises medical device companies on Medicare coverage and reimbursement issues, helping them navigate the requirements that affect whether and how their products are covered and paid for.

For clients that regularly interact or partner with CMS, Dave brings a practical understanding of how the agency operates, how healthcare policies and programs develop, how agency officials consider market and programmatic implications, and how to communicate complex issues effectively with regulators. He closely follows agency priorities, policy developments, and evolving payment and care-delivery approaches so clients can understand how changes may affect their organizations. When CMS seeks input from stakeholders as it develops or refines programs and policies, Dave shares practical market feedback and advocates for the industry on how proposed approaches may affect providers and payors.

Dave’s perspective is particularly valuable when a CMS policy, audit position, or regulatory approach creates a business obstacle. Dave helps clients move beyond identifying the legal issue to determine how best to address it — framing the concern, identifying the appropriate avenue for engagement, and developing potential solutions that account for both the client’s objectives and CMS’ policy and programmatic priorities. His strategy combines regulatory analysis, market knowledge, contracting experience, and an understanding of government decision-making to help clients develop practical paths forward.