Andrew Z. Ko
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Andrew Ko represents health care providers with challenging audits conducted by the New York State Office of the Medicaid Inspector General (OMIG), the Office for People with Developmental Disabilities (OPWDD), Centers for Medicare & Medicaid Services (CMS), and Special Investigation Units (SIU) of health insurance companies. He has contested the statistical sampling and extrapolation methodology implemented to calculate the purported overpayments.
Andrew advises clients on responding to government investigations, self-disclosures and voluntary repayments as well as record requests by health insurance companies and government agencies, including Additional Documentation Requests (ADRs) by Medicare.
Andrew assists clients in developing and implementing effective compliance programs, compliance program training, and responding to compliance program reviews conducted by OMIG.
Additionally, Andrew represents health care providers with enrollment issues, deactivation of billing privileges and revocations by Medicare and Medicaid. This includes representing pharmacies whose privileges have been revoked for alleged non-compliance with Medicare Part B and Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) standards. He has successfully disputed these issues surrounding supplier requirements through the submission of Corrective Action Plans and Reconsiderations.
Prior to joining the firm, Andrew worked as a health law associate for a regional law firm. He also was an Appellate Court Attorney at the State of New York Supreme Court, Appellate Division, Third Judicial Department, where he conducted legal research and drafted preliminary reports for the Court.
Super Lawyers has recognized Garfunkel Wild Attorneys across a range of the firm’s practice areas to the 2025 Super Lawyers and Rising Stars list.
Thirty-Eight Garfunkel Wild attorneys were selected by their peers for inclusion in the 2024 editions of The Best Lawyers in America and The Best Lawyers: Ones to Watch.
Thirty-Three Garfunkel Wild attorneys were selected by their peers for inclusion in 2022 New York Metro Super Lawyers, and 2022 New York Metro/Upstate New York Rising Stars.
Thirty Five Garfunkel Wild attorneys were selected by their peers for inclusion in the 2023 The Best Lawyers in America® guide and the Best Lawyers “Ones to Watch” list. In addition, Partner Jason Y. Hsi was honored as “Lawyer of the Year” in the area of Litigation – Health Care Law.
Garfunkel Wild received prominent recognition in the 2025 editions of The Best Lawyers in America and The Best Lawyers in America: Ones to Watch. A total of 38 attorneys were honored with 59 individual recognitions across various practices and offices nationwide. Additionally, 3 Garfunkel Wild attorneys were distinguished as Lawyer of the Year, an accolade awarded to only one […]
Super Lawyers has recognized 36 Garfunkel Wild Attorneys across a range of the firm’s practice areas to the 2024 Super Lawyers and Rising Stars list.
Garfunkel Wild received prominent recognition in the 2026 editions of The Best Lawyers in America® and The Best Lawyers in America: Ones to Watch®. A total of 31 attorneys were honored with 47 individual recognitions across various practice areas and offices nationwide. Additionally, 1 Garfunkel Wild attorney was distinguished as Lawyer of the Year in Long Island for Litigation - Health Care, an accolade awarded to only one lawyer per practice area in each major U.S. market.
Access to and the cost of health care for children with complex medical needs is a significant burden for many families. Grants can serve as an important lifeline that allows families to obtain and afford medically necessary and appropriate care for their children. The U.S. Department of Health and Human Services, Office of Inspector General’s (OIG) favorable advisory opinion (25-10) is another positive step towards ensuring that children with special medical needs receive timely and affordable care.
OIG issued an unfavorable opinion (25-08) in which a medical device company proposed to pay a third-party vendor a yearly flat fee to access Vendor’s electronic billing portal.
The U.S. Department of Health and Human Services, Office of Inspector General (OIG), recently issued a favorable Advisory Opinion (25-03) regarding a proposed arrangement (Arrangement) where a non-clinical management support organization and an affiliated professional corporation wholly owned by physician shareholders (PC) enters into lease agreements with telehealth platforms (Platforms) and providers employed by or contracted with these Platforms (Platform Providers).
The U.S. Department of Justice, Criminal Division (DOJ) recently and unexpectedly announced changes to the manner in which it handles criminal investigations and prosecutions of white-collar and corporate cases. These changes are aimed at clarifying DOJ’s criminal enforcement priorities, increasing the efficiency with which cases are investigated and resolved, and emphasizing the benefits of voluntarily self-disclosing potential misconduct. They also signal a more business-friendly approach than in the past, and will be undoubtedly welcomed by corporations and executives alike.
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (25-01) allowing a Pharmaceutical Company (Company) to provide free access to its U.S. Food and Drug Administration (FDA)-approved product (Product) for eligible patients with mild cognitive impairment or disease-related dementia and related symptoms.
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (24-12) allowing a pharmaceutical manufacturer (Manufacturer) to sponsor a genetic testing, genetic counseling, and disease-state awareness education program for certain eligible patients with an “ultra-rare” genetic condition that causes kidney stones.
On December 11, 2024, the U.S. Department of Health and Human Services, Office of the Inspector General (OIG) published a Special Fraud Alert in response to the uptick in abusive marketing practices between Medicare Advantage Organizations (MAOs), health care providers, and ancillary participants (such as agents and brokers).
This week, the U.S. Department of Health and Human Services (“HHS”), Office of Inspector General (“OIG”) fulfilled its annual statutory obligation by releasing its 2024 Top Management and Performance Challenges Report (the “Report”). Historically, the Report has not attracted widespread interest in the provider community because it largely focuses on HHS operational challenges. Importantly for providers and other stakeholders, however, the Report reveals crucial insights about compliance priorities for the year ahead.
OIG posted a partially favorable Advisory Opinion (24-05) permitting a biotechnology company to provide transportation, lodging, and payment of associated expenses for certain patients receiving gene therapy treatments for two severe genetic diseases. In the same Advisory Opinion, however, OIG responded unfavorably to the Company’s proposal to subsidize some or all costs related to fertility preservation and storage procedures for these same patients.
Pharmacy revocations for non-compliance with Medicare Part B and Durable Medical Equipment, Prosthetics, Orthotics and Supplies enrollment requirements are on the rise. Garfunkel Wild’s latest webinar in our Compliance Webinar Series discusses common risks and provides strategies to protect your pharmacy.
The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) released its revamped Semiannual Report (SAR) on June 3, 2024. The SAR’s new format focuses on the oversight work OIG completed during the reporting period, and emphasizes how this work directly addresses the Top Management Challenges Facing HHS.
Garfunkel’s Compliance Webinar Series rolls on with an examination of the 2024 Work Plan published by the New York State Office of Medicaid Inspector General (OMIG).
The United States Department of Health and Human Services (HHS), Office of Inspector General (OIG) recently posted a new educational resource on its website about Single Audits. HHS is the largest grant-making agency in the Federal government, and OIG’s new resource is designed to help key stakeholders understand the scope of Single Audits, as well as improve the overall quality of such audits.
The New York State Office of the Medicaid Inspector General (OMIG) recently updated its Self-Disclosure Guidance and Frequently Asked Questions (collectively, “Updates”). These Updates give participating providers and entities additional insight into how to report overpayments involving unresponsive Medicaid Managed Care Organizations (MMCOs) or multiple entities, as well as those that are untimely, have adjusted or voided claims, or lost or damaged records.
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-11) that allows a medical device manufacturer (Manufacturer) to subsidize Medicare cost-sharing obligations as part of a U.S. Food & Drug Administration (FDA)-approved clinical study involving a Category B Investigational Device Exemption.
Continuing its year-end reporting blitz, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Semiannual Report (SAR) to Congress on December 1, 2023.
On December 28, 2022, the New York State Office of the Medicaid Inspector General (“OMIG”) finalized a significant set of new compliance-related regulations. The rules were initially proposed on July 13, 2022 (see our prior Client Alert on the proposed rules here: https://www.garfunkelwild.com/insights/omig-proposes-significant-new-compliance-program-regulations). The final rules contain minimal revisions to the proposed regulations.
Additional speaking & writing
Publications
- Legal and Ethical Concerns of Telehealth and Telemedicine, 26 NYSBA Health L.J. 37 (2021)
- Electronic Monitoring in Nursing Homes, Albany County Bar Association Newsletter 15 (March 2019)
Andrew Ko represents health care providers with challenging audits conducted by the New York State Office of the Medicaid Inspector General (OMIG), the Office for People with Developmental Disabilities (OPWDD), Centers for Medicare & Medicaid Services (CMS), and Special Investigation Units (SIU) of health insurance companies. He has contested the statistical sampling and extrapolation methodology implemented to calculate the purported overpayments.
Andrew advises clients on responding to government investigations, self-disclosures and voluntary repayments as well as record requests by health insurance companies and government agencies, including Additional Documentation Requests (ADRs) by Medicare.
Andrew assists clients in developing and implementing effective compliance programs, compliance program training, and responding to compliance program reviews conducted by OMIG.
Additionally, Andrew represents health care providers with enrollment issues, deactivation of billing privileges and revocations by Medicare and Medicaid. This includes representing pharmacies whose privileges have been revoked for alleged non-compliance with Medicare Part B and Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) standards. He has successfully disputed these issues surrounding supplier requirements through the submission of Corrective Action Plans and Reconsiderations.
Prior to joining the firm, Andrew worked as a health law associate for a regional law firm. He also was an Appellate Court Attorney at the State of New York Supreme Court, Appellate Division, Third Judicial Department, where he conducted legal research and drafted preliminary reports for the Court.
The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) released its revamped Semiannual Report (SAR) on June 3, 2024. The SAR’s new format focuses on the oversight work OIG completed during the reporting period, and emphasizes how this work directly addresses the Top Management Challenges Facing HHS.
The United States Department of Health and Human Services (HHS), Office of Inspector General (OIG) recently posted a new educational resource on its website about Single Audits. HHS is the largest grant-making agency in the Federal government, and OIG’s new resource is designed to help key stakeholders understand the scope of Single Audits, as well as improve the overall quality of such audits.
The New York State Office of the Medicaid Inspector General (OMIG) recently updated its Self-Disclosure Guidance and Frequently Asked Questions (collectively, “Updates”). These Updates give participating providers and entities additional insight into how to report overpayments involving unresponsive Medicaid Managed Care Organizations (MMCOs) or multiple entities, as well as those that are untimely, have adjusted or voided claims, or lost or damaged records.
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-11) that allows a medical device manufacturer (Manufacturer) to subsidize Medicare cost-sharing obligations as part of a U.S. Food & Drug Administration (FDA)-approved clinical study involving a Category B Investigational Device Exemption.
Continuing its year-end reporting blitz, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Semiannual Report (SAR) to Congress on December 1, 2023.
Garfunkel’s Compliance Webinar Series rolls on with an examination of the 2024 Work Plan published by the New York State Office of Medicaid Inspector General (OMIG).
Pharmacy revocations for non-compliance with Medicare Part B and Durable Medical Equipment, Prosthetics, Orthotics and Supplies enrollment requirements are on the rise. Garfunkel Wild’s latest webinar in our Compliance Webinar Series discusses common risks and provides strategies to protect your pharmacy.
OIG posted a partially favorable Advisory Opinion (24-05) permitting a biotechnology company to provide transportation, lodging, and payment of associated expenses for certain patients receiving gene therapy treatments for two severe genetic diseases. In the same Advisory Opinion, however, OIG responded unfavorably to the Company’s proposal to subsidize some or all costs related to fertility preservation and storage procedures for these same patients.
On December 28, 2022, the New York State Office of the Medicaid Inspector General (“OMIG”) finalized a significant set of new compliance-related regulations. The rules were initially proposed on July 13, 2022 (see our prior Client Alert on the proposed rules here: https://www.garfunkelwild.com/insights/omig-proposes-significant-new-compliance-program-regulations). The final rules contain minimal revisions to the proposed regulations.
This week, the U.S. Department of Health and Human Services (“HHS”), Office of Inspector General (“OIG”) fulfilled its annual statutory obligation by releasing its 2024 Top Management and Performance Challenges Report (the “Report”). Historically, the Report has not attracted widespread interest in the provider community because it largely focuses on HHS operational challenges. Importantly for providers and other stakeholders, however, the Report reveals crucial insights about compliance priorities for the year ahead.
On December 11, 2024, the U.S. Department of Health and Human Services, Office of the Inspector General (OIG) published a Special Fraud Alert in response to the uptick in abusive marketing practices between Medicare Advantage Organizations (MAOs), health care providers, and ancillary participants (such as agents and brokers).
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (24-12) allowing a pharmaceutical manufacturer (Manufacturer) to sponsor a genetic testing, genetic counseling, and disease-state awareness education program for certain eligible patients with an “ultra-rare” genetic condition that causes kidney stones.
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (25-01) allowing a Pharmaceutical Company (Company) to provide free access to its U.S. Food and Drug Administration (FDA)-approved product (Product) for eligible patients with mild cognitive impairment or disease-related dementia and related symptoms.
The U.S. Department of Justice, Criminal Division (DOJ) recently and unexpectedly announced changes to the manner in which it handles criminal investigations and prosecutions of white-collar and corporate cases. These changes are aimed at clarifying DOJ’s criminal enforcement priorities, increasing the efficiency with which cases are investigated and resolved, and emphasizing the benefits of voluntarily self-disclosing potential misconduct. They also signal a more business-friendly approach than in the past, and will be undoubtedly welcomed by corporations and executives alike.
The U.S. Department of Health and Human Services, Office of Inspector General (OIG), recently issued a favorable Advisory Opinion (25-03) regarding a proposed arrangement (Arrangement) where a non-clinical management support organization and an affiliated professional corporation wholly owned by physician shareholders (PC) enters into lease agreements with telehealth platforms (Platforms) and providers employed by or contracted with these Platforms (Platform Providers).
OIG issued an unfavorable opinion (25-08) in which a medical device company proposed to pay a third-party vendor a yearly flat fee to access Vendor’s electronic billing portal.
Access to and the cost of health care for children with complex medical needs is a significant burden for many families. Grants can serve as an important lifeline that allows families to obtain and afford medically necessary and appropriate care for their children. The U.S. Department of Health and Human Services, Office of Inspector General’s (OIG) favorable advisory opinion (25-10) is another positive step towards ensuring that children with special medical needs receive timely and affordable care.
Access to and the cost of health care for children with complex medical needs is a significant burden for many families. Grants can serve as an important lifeline that allows families to obtain and afford medically necessary and appropriate care for their children. The U.S. Department of Health and Human Services, Office of Inspector General’s (OIG) favorable advisory opinion (25-10) is another positive step towards ensuring that children with special medical needs receive timely and affordable care.
OIG issued an unfavorable opinion (25-08) in which a medical device company proposed to pay a third-party vendor a yearly flat fee to access Vendor’s electronic billing portal.
The U.S. Department of Health and Human Services, Office of Inspector General (OIG), recently issued a favorable Advisory Opinion (25-03) regarding a proposed arrangement (Arrangement) where a non-clinical management support organization and an affiliated professional corporation wholly owned by physician shareholders (PC) enters into lease agreements with telehealth platforms (Platforms) and providers employed by or contracted with these Platforms (Platform Providers).
The U.S. Department of Justice, Criminal Division (DOJ) recently and unexpectedly announced changes to the manner in which it handles criminal investigations and prosecutions of white-collar and corporate cases. These changes are aimed at clarifying DOJ’s criminal enforcement priorities, increasing the efficiency with which cases are investigated and resolved, and emphasizing the benefits of voluntarily self-disclosing potential misconduct. They also signal a more business-friendly approach than in the past, and will be undoubtedly welcomed by corporations and executives alike.
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (25-01) allowing a Pharmaceutical Company (Company) to provide free access to its U.S. Food and Drug Administration (FDA)-approved product (Product) for eligible patients with mild cognitive impairment or disease-related dementia and related symptoms.
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (24-12) allowing a pharmaceutical manufacturer (Manufacturer) to sponsor a genetic testing, genetic counseling, and disease-state awareness education program for certain eligible patients with an “ultra-rare” genetic condition that causes kidney stones.
On December 11, 2024, the U.S. Department of Health and Human Services, Office of the Inspector General (OIG) published a Special Fraud Alert in response to the uptick in abusive marketing practices between Medicare Advantage Organizations (MAOs), health care providers, and ancillary participants (such as agents and brokers).
This week, the U.S. Department of Health and Human Services (“HHS”), Office of Inspector General (“OIG”) fulfilled its annual statutory obligation by releasing its 2024 Top Management and Performance Challenges Report (the “Report”). Historically, the Report has not attracted widespread interest in the provider community because it largely focuses on HHS operational challenges. Importantly for providers and other stakeholders, however, the Report reveals crucial insights about compliance priorities for the year ahead.
OIG posted a partially favorable Advisory Opinion (24-05) permitting a biotechnology company to provide transportation, lodging, and payment of associated expenses for certain patients receiving gene therapy treatments for two severe genetic diseases. In the same Advisory Opinion, however, OIG responded unfavorably to the Company’s proposal to subsidize some or all costs related to fertility preservation and storage procedures for these same patients.
Pharmacy revocations for non-compliance with Medicare Part B and Durable Medical Equipment, Prosthetics, Orthotics and Supplies enrollment requirements are on the rise. Garfunkel Wild’s latest webinar in our Compliance Webinar Series discusses common risks and provides strategies to protect your pharmacy.
The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) released its revamped Semiannual Report (SAR) on June 3, 2024. The SAR’s new format focuses on the oversight work OIG completed during the reporting period, and emphasizes how this work directly addresses the Top Management Challenges Facing HHS.
Garfunkel’s Compliance Webinar Series rolls on with an examination of the 2024 Work Plan published by the New York State Office of Medicaid Inspector General (OMIG).
The United States Department of Health and Human Services (HHS), Office of Inspector General (OIG) recently posted a new educational resource on its website about Single Audits. HHS is the largest grant-making agency in the Federal government, and OIG’s new resource is designed to help key stakeholders understand the scope of Single Audits, as well as improve the overall quality of such audits.
The New York State Office of the Medicaid Inspector General (OMIG) recently updated its Self-Disclosure Guidance and Frequently Asked Questions (collectively, “Updates”). These Updates give participating providers and entities additional insight into how to report overpayments involving unresponsive Medicaid Managed Care Organizations (MMCOs) or multiple entities, as well as those that are untimely, have adjusted or voided claims, or lost or damaged records.
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-11) that allows a medical device manufacturer (Manufacturer) to subsidize Medicare cost-sharing obligations as part of a U.S. Food & Drug Administration (FDA)-approved clinical study involving a Category B Investigational Device Exemption.
Continuing its year-end reporting blitz, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Semiannual Report (SAR) to Congress on December 1, 2023.
On December 28, 2022, the New York State Office of the Medicaid Inspector General (“OMIG”) finalized a significant set of new compliance-related regulations. The rules were initially proposed on July 13, 2022 (see our prior Client Alert on the proposed rules here: https://www.garfunkelwild.com/insights/omig-proposes-significant-new-compliance-program-regulations). The final rules contain minimal revisions to the proposed regulations.
Additional speaking & writing
Publications
- Legal and Ethical Concerns of Telehealth and Telemedicine, 26 NYSBA Health L.J. 37 (2021)
- Electronic Monitoring in Nursing Homes, Albany County Bar Association Newsletter 15 (March 2019)
Practices
Education
- summa cum laude
- Executive Editor for New York Appeals of the Albany Law Review
- magna cum laude
- Business and Management
Court admissions
U.S. District Court: Northern District of New York
U.S. District Court: Southern District of New York
U.S. District Court: Eastern District of New York
AWARDS & RANKINGS
- Best Lawyers in America® Ones to Watch – Corporate Law (2023-2026) and Health Care Law (2024-2026)
- Super Lawyers – Upstate New York Rising Star (2021-2025)
- NYSBA House of Delegates for the Third Department (2022)
