Celebrating 125 Years

Carla J. Cox


Carla J. Cox is an experienced health care regulatory lawyer who represents numerous types of health care providers in state and federal health care regulatory and enforcement matters. Examples of the types of matters Ms. Cox handles include license revocation appeals, appeals of Medicare/Medicaid terminations, appeals of state and federal civil monetary penalties, and Medicare/Medicaid reimbursement matters. She also represents health care clients in health care compliance matters such as developing compliance plans, conducting compliance audits, investigating and self-reporting possible Medicare/Medicaid fraud and abuse, and defending civil actions alleging Medicare/Medicaid fraud and abuse filed by state and federal enforcement agencies such as the Office of Inspector General and the Texas Attorney General's office. Ms. Cox has experience with the Texas Medicaid Star and Star+Plus managed care programs. She also represents clients in appeals of audit determinations by Medicaid Recovery Audit Contractors (RACs) and Medicaid Integrity Contractors (MICs).

Ms. Cox also represents health care facilities, assisted living facilities, and retirement communities as regulatory counsel in connection with sales and acquisitions. She assists clients with regulatory due diligence, license applications, and Medicare/Medicaid changes of ownership.

Ms. Cox has also represented diverse clients in connection with procurement and contracting matters involving Texas governmental agencies. She has represented successful bidders in defending challenges to bid awards as well as unsuccessful bidders in assessing and/or challenging awards to other bidders. Ms. Cox also represents clients in the administrative process provided in Texas for resolving contract disputes with governmental agencies.

Ms. Cox has extensive litigation experience in both state and federal court. Her litigation experience includes suits for declaratory and injunctive relief against state regulatory agencies as well as appeals of decisions by administrative agencies in state and federal court. She has briefed and argued a number of appellate cases in the Texas Court of Appeals, the Texas Supreme Court, and the federal 5th Circuit Court of Appeals.

Ms. Cox has extensive experience representing clients before state administrative agencies including the following:
  • Texas Department of Aging and Disability Services—Appeals of administrative and civil monetary penalties, appeals of Medicaid TILE audits, appeals of Medicaid terminations, and assistance with licensing and Medicaid reimbursement questions involving nursing homes, assisted living facilities, and ICF/MR facilities.

  • Texas Department of State Health Services—Appeals of adverse licensure actions and assistance with licensing issues involving hospitals and food manufacturers and distributors.

  • Texas Health and Human Services Commission—Assistance with Medicaid reimbursement issues involving health care providers. Negotiating contractual disputes for entities that contract with HHSC.

  • Texas Medical Board—Represents physicians in connection with Board investigations and adverse licensure actions.

  • Texas Board of Nursing—Represents nurses in connection with Board investigations and adverse licensure actions.

  • Texas Board of Pharmacy—Represents pharmacists in connection with Board investigations and adverse licensure actions.

  • Texas Nursing Facility Administrators Advisory Committee—Represents nursing home administrators in connection with investigations and adverse licensure actions.

  • Texas Department of Family and Protective Services—Assistance with investigations and adverse licensure actions against child care facilities, child placement (foster care) agencies, and long term residential treatment facilities.

On the federal level, Ms. Cox has represented clients before the Department of Health and Human Services Departmental Appeals Board (Medicare/Medicaid termination and exclusion), the Provider Reimbursement Review Board, and in connection with investigations of Medicare/Medicaid fraud by the Office of Inspector General.

Attorney Profile: Carla Cox — Helping clients' businesses stay healthy

More about Carla J. Cox: Involvement | Speeches / Publications | News

Organization Membership

Ms. Cox is a member of the State Bar of Texas, Health Law and Administrative Law Sections, the American Health Lawyers Association, the Health Care Compliance Association, the Austin Health Lawyers Association, the Texas Health Care Association, and the Travis County Bar Association.

Community Involvement

Ms. Cox is a member of the Circle of Leaders of the University of Texas Center for Women in Law and the University of Texas System Chancellor’s Council. She is a past President of the Board of Directors of the Central Texas Ronald McDonald House in Austin and is involved in a number of other civic and charitable activities, including AIDS Services of Austin and the Austin United Way Women's Leadership Council.

More about Carla J. Cox: Biography | Speeches / Publications | News

Speeches / Publications

Ms. Cox is a frequent author and speaker and has spoken or written on a wide variety of topics including "Fraud & Abuse, False Claims, Qui Tam Actions - the Basics and Beyond," "HIPAA Privacy and Security in the New Millennium," "How to Reduce Civil and Administrative Monetary Penalties," "New Laws and Regulations Affecting Assisted Living Facilities," "Texas Laws Regarding Reporting Patient Deaths, Medicaid Fraud and Anti-Kickback," "Effective Representation of Licensees in Revocation Proceedings," "Enforcement and Malpractice Update," "Negotiated Risk...a tool to escape liability?," "Regulatory and Compliance Issues Surrounding Physician Referral," "Update on Nursing Facilities Administrators' Licensure," "New State Regulatory Updates: Understand How They Affect You," and "Law and Legal Issues for Texas Cranes." Ms. Cox acts as a primary editor of Health Brief, Jackson Walker's health care industry newsletter.

Links to Publications

More about Carla J. Cox: Biography | Involvement | News

  • Carla J. Cox
Austin Office
T: 512.236.2040
F: 512.391.2140

Administrative Law
Practice Areas

B.A., The University of Texas at Austin

J.D., The University of Texas School of Law
Bar Admissions

  • 1977, Texas
Court Admissions

  • United States Court of Appeals for the Fifth Circuit
  • United States District Courts for the Western and Northern Districts of Texas
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