Kristen focuses her practice in the area of Medicaid and Medicare program reimbursement, providing seasoned legal and consulting services to all providers, state agencies, lenders and contractors. Her vast array of experience and deep understanding of Medicaid and Medicare program reimbursement are reflected in the following representative experience:
- Design and implementation of Medicaid Supplemental Payment (Upper Payment Limit) programs, Medicaid Disproportionate Share Hospital programs and Medicaid Administrative Claiming programs in Indiana, Illinois, Idaho, Michigan, Utah and Wyoming (see below for more).
- General representation of entities participating in Medicaid Supplemental Payment (Upper Payment Limit) programs, Medicaid Disproportionate Share Hospital programs and Medicaid Administrative Claiming programs.
- Representation of providers in front of state and federal agencies and their third party contractors (included managed care entities), state professional licensing and facility licensing boards, state Medicaid agencies (and managed care contractors), Medicaid Fraud Control Units, state attorney general offices, the Centers for Medicare and Medicaid Services and their Medicare Administrative Contractors, the Provider Reimbursement Review Board and the Departmental Appeals Board.
- Representation of manufacturers in front of state and federal agencies, including pharmacy boards, Medicare contractors, the Healthcare Common Procedure Coding System and the American Medical Association CPT Editorial Panel.
- Analysis and evaluation of complex business relationships of providers to determine compliance under the various state and federal fraud and abuse laws, including the False Claims Act, Anti-Kickback Statute, Physician Self-Referral Law (Stark), Exclusion Authorities and Civil Monetary Penalties Law and assisting providers with obtaining favorable Office of Inspector General opinions.
- Experience in 340B pricing for manufacturers, covered entities and contractors.
- General healthcare representation of healthcare providers and their contractors, including physician groups, hospitals, dentists, dental clinics, ambulatory surgery centers, DME and drug manufacturers, pharmacies, managed care plans, third party administrators, pharmacy benefit managers, etc.
Kristen is known throughout the country for her experience in the very specialized area of Medicaid Supplemental Payment (also known as Medicaid Upper Payment Limit) programs. She has worked in a number of states including Indiana, Illinois, Michigan, Texas, Utah, Wyoming and Montana and has worked with providers and State Medicaid agencies to create and implement these programs. She has worked with a variety of health care provider-types in the creation and implementation of these programs including hospitals, physicians, nursing facilities, dental clinics and ambulance services. With respect to nursing facility Medicaid Supplemental Payment (Upper Payment Limit) programs, Kristen has worked with county and city hospitals and managers of the facilities and has advised lenders who work with the hospitals and managers. She is one of the most knowledgeable and experienced individuals in the country in this area.
Representative Medicaid Supplemental Payment programs experience includes:
- The Indiana, Utah, Texas and Wyoming Medicaid non-state governmental nursing facility programs.
- The Michigan Community Dental Clinics Medicaid non-state governmental dental clinic program.
- The Indiana and Michigan Medicaid physician supplemental payment programs.
- The Indiana hospital inpatient and outpatient hospital supplemental payment programs.
- The Indiana Medicaid ambulance supplemental payment program.
Honoree, Indiana Super Lawyers Rising Stars (2013 - 2016)
All Service Areas
- Indiana University - Robert H. McKinney School of Law (2002)
- Indiana University (1998)
- State - Indiana
- Federal - Northern District of Indiana
- Federal - Southern District of Indiana
- American Bar Association
- American Health Lawyers Association
- Indianapolis Bar Association
- Executive Women in Healthcare
- Indiana Benefits Conference
- American Heart Association
Member, Go Red for Women
Member, Circle of Red
- Gennesaret Free Clinic