Concentrating
exclusively in health care law, Carolyn advises physicians, hospitals,
long-term facilities and other health care entities on federal and state
regulatory issues, fraud and abuse statutes, physician self-referral laws
(Stark), HIPAA, structuring business ventures in compliance with government
regulations, Medicare/Medicaid reimbursement, and compliance program
management. She represents health care providers before professional licensing
boards and medical staff and peer review matters, reimbursement appeals, and
business disputes. She advises providers in transactional and operational
matters, such as the establishment of physician practices, the development of
employment and shareholder agreements, and the structuring of compensation
arrangements.
Practice Highlights
- Unwound three major medical practices and successfully negotiated terms without litigation or alternative dispute resolution and no interruption of practice business.
- Represented a physician practice in a reimbursement issue with Medicare in which the practice was allowed to retain $100,000 in contested fees.
- Regularly represents
providers in Medicare appeals and recently successfully argued before the ALJ
an appeal that allowed the provider to recoup over $100,000.
- Successfully structured business ventures between hospitals and physicians in compliance with fraud and abuse, physician self-referral and tax-exempt laws.
- Successfully defended a
local hospital in U.S. District Court in a multi-million dollar claim commenced
by a surgeon as a result of his medical privileges being summarily suspended at
the recommendation of the hospital’s medical staff. The action asserted claims
for deprivation of due process, freedom of speech, breach of contract, slander
and contract interference.
Presentations
- "Red Flags, HITECH, and RAC Audits" (Mountain Area Health Education Center, 2009)
- “Red Flag Rules” (WNC Medical Group Managers, 2009)
- “The Business of Healthcare” (University of North Carolina Festival of Legal Learning, 2006 - 2009)
- “Patient Care Issues” (Mountain Area Health Education Center, 2002 - 2009)
- “Hot Topics – Stark, Anti-Markup Rule, Incident To Rules” (WNC Medical Group Managers, 2008)
- “Successful Collaborations Between Group Practices and Hospitals” (Buncombe County Medical Society, 2008)
- “Confidentiality of Medical Records in North Carolina” (Lorman Educational Services, 2002 - 2008)
- “Legal Overview of Healthcare Issues” (Buncombe County Medical Society’s Annual Practice Managers Seminar, 2002 - 2008)
Professional Affiliations
- 28th Judicial District Bar, 1999-present
- American Health Lawyers Association, 2000-present
- North Carolina Bar Association, 1999-present
- North Carolina State Bar, 1999-present
- Elected to Business North Carolina Legal Elite in 2009
