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Ms. Abrahamsen's practice is devoted to representation of health care facilities and practitioners in corporate and regulatory matters, with emphasis on medical staff matters, reimbursement, and regulation of hospital-physician financial relationships.
Experience
Hospital-physician joint ventures. Structure joint ownership of ambulatory surgery centers and diagnostic services, addressing anti-kickback, Stark, licensure, certification, and securities law issues.
Medical staff - hospital relations. Draft medical staff bylaws and policies. Experience in streamlining medical staff appeal procedures, disruptive and impaired practitioner policies, and compliance with JCAHO and AOA medical staff standards. Counsel medical executive committees regarding difficult credentialing cases and regarding practical steps to reduce antitrust risk and maximize peer review confidentiality.
Joint Commission on Accreditation of Healthcare Organizations. Counsel clients on compliance with JCAHO accreditation standards. Represent clients in appeals of adverse accreditation decisions.
Stark and other physician self-referral laws. Structure professional practices and transactions to achieve client business objectives while complying with applicable legal restrictions on referral. Ms. Abrahamsen chaired the Michigan State Bar Stark Task Forces, which drafted and submitted comments to the federal government regarding the 2001 and 2004 Stark Regulations.
Hospital-physician contracts. Counsel regarding application of tax, Stark and anti-kickback laws to physician recruitment contracts. Draft hospital-based physician contracts, including addressing clinical service objectives, exclusivity, and reimbursement issues.
Counsel regarding compliance issues, such as identification and application of reimbursement rules and responding to overpayments.
Frequent contacts with Medicare intermediary, carrier, CMS regional office and CMS central office, Blue Cross Blue Shield, and Medicaid programs regarding reimbursement policy issues.
Appeal Medicare, Medicaid and non-government reimbursement decisions and represent providers in payor audits and disputes.
Structure businesses and transactions to maximize allowable payment and comply with payor requirements.
Extensive counseling of clients regarding third party reimbursement.
Professional practices. Structure office-sharing arrangements among practitioners, practice management contracts, and traditional group practice structures such as PCs and PLLCs. Address employment issues, contracts and patient forms and policies.
Seminars and Speeches
10/2005 Ambulatory Joint Ventures, Health Care Financial Management Association, Annual Michigan Conference
4/2005 Legal Issues Relating to Medical Staff Bylaws, Rules and Regulations, Michigan Association of Medical Staff Services Annual Meeting
4/2005 Reimbursement Update and Stark Update, Healthcare Financial Management Association, Great Lakes Chapter
3/2005 Federal Regulatory Update, Institute for Continuing Legal Education, Health Law Institute
4/2004 Regulatory and Reimbursement Update and FAQ Regarding Financial Relationships with Physicians, Health Care Financial Management Association, Great Lakes Chapter
10/2003 How to Attract OIG Attention, Health Care Financial Management Association Annual Michigan Conference
9/2003 Health Law Update, Oakland County Bar Association Law Day Seminar
3/2003 Reimbursement and Regulatory Developments and Medical Research Compliance Issues, Health Care Financial Management Association, Great Lakes Chapter
3/2003 Federal Health Law Update, Institute for Continuing Legal Education Health Law Institute
3/2003 Federal Regulatory Issues, Health Care Financial Management Association, Annual Insurance and Reimbursement Update
12/2002 Michigan Prompt Pay Legislation, Healthcare Financial Management Association Patient Accounting Committee
11/2002 Stark Law, St. Joseph Mercy-Oakland Medical Staff Compliance Series
11/2002 Medicare Provider-Based Rules, Healthcare Financial Management Association Physician Practices Committee
10/2002 Diagnostic Compliance Issues, Healthcare Financial Management Association Annual Michigan Conference
4/2002 Peer Review Confidentiality in Michigan, Michigan Association of Medical Staff Services Annual Meeting
3/2002 Key Compliance Issues for 2002, Health Care Financial Management Association, Great Lakes Chapter
3/2002 Negotiating Payer-Provider Contracts: Avoiding Regulatory Perils and Pitfalls, Institute for Continuing Legal Education Health Law Institute
3/2002 Managed Care Compliance Issues, Institute for Continuing Legal Education Health Law Institute
3/2002 Reimbursement Update and Physician Recruitment, Healthcare Financial Management Association, Great Lakes Chapter
3/2002 Provider Discounting, Michigan Patient Accounting Association
10/2001 Discounting and Co-Pay Waivers, Healthcare Financial Management Association, Michigan Fall Conference
10/2001 Pharmacy Managed Care Contracting, National Association of Chain Drug Stores Fall Conference, San Antonio
5/2001 Hot Topics in Medicare Compliance, Healthcare Financial Management Association, Eastern Michigan Chapter
3/2001 Federal Health Law Update, Institute for Continuing Legal Education, Health Law Institute
2/2001 Health Care Corporate Compliance, Healthcare Financial Management Association, Great Lakes Chapter
11/2000 Provider Self-Disclosure, Health Care Compliance Association
8/2000 Health Care Compliance, Lorman Education
8/2000 Pharmacy Managed Care Contracting, National Association of Chain Drug Stores Annual Meeting, San Diego
3/2000 Federal Health Law Update, Institute for Continuing Legal Education, Health Law Institute
Publications
2005 Improving Quality in EMS, "EMS Quality Improvement and The Law," (2nd ed., National Association of EMS Physicians)
2005 The Biggest Legal Mistakes Physicians Make and How To Avoid Them, "The 10 Biggest Legal Mistakes Physicians Make in Managed Care Contracting," (SEAK, Inc.)
NACDS Managed Care Contracting Manual - Prescription Drug Programs, (National Association of Chain Drug Stores, editor of 1998 and 2001 eds.)
Professional Associations
American Health Lawyers Association, member
Detroit Metropolitan Bar Association - Wayne County Medical Society Medical-Legal Committee (past member and chairperson)
Health Care Financial Management Association, Eastern Michigan (past director, and past chairperson of Health Law Committee)
State Bar of Michigan, Health Law Section Council (member 1994 - 2000, chair 1998 - 1999, chair Stark Regulation Task Forces 2001 and 2004)
Michigan State Medical Society Committee on Medical & Legal Issues (past member)
Oakland County Bar Association - Oakland County Medical Society Medical-Legal Committee (present)
Awards
Detroit Bar Association, Chairperson of the Year 1995
Named 2006 Michigan Super Lawyer by Law & Politics
The Best Lawyers in America, Health Care, selected 2001-2007.
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