Kathleen assists health care organizations and providers in navigating the regulatory maze that is the hallmark of health care in the United States today. Her practice areas include the following:
Fraud & Abuse - establishment and evaluation of corporate compliance programs and advice on federal and NYS fraud and abuse issues, such as anti-kickback and physician self-referral (Stark) laws, civil monetary penalties, false claims and other compliance-related issues.
Health Insurance Portability and Accountability Act (HIPAA) - advice on all aspects of HIPAA Privacy Rule and HIPAA Security Rule implementation and compliance, including uses and disclosures of confidential information, incidental disclosures and reasonable safeguards, patient rights, minimum necessary requirements, consent versus authorization, business associate agreements, etc.
Home Health – advice on the rights and obligations of home health entities under federal and NYS laws and regulations, including patient rights, payment for services, personnel standards, plans of care, quality improvement activities, services offered, etc.
Hospitals – advice on the rights and obligations of hospitals under federal and NYS laws and regulations, including credentialing, discharge planning, emergency care, patient rights, payment for services and utilization management.
Managed Care – advice on the application of federal and NYS laws and regulations and NCQA standards to all aspects of managed care operations, including claims processing and payment, credentialing, grievances and appeals, member rights, provider relations and utilization review.
Risk Management – advice on risk management issues facing health care organizations and providers, such as advance directives (DNRs, health care proxies, living wills), confidentiality of medical records, confidentiality of quality improvement documents, informed consent, medical record documentation and terminating the physician/patient relationship.