New CMS Guidance Forthcoming on Provider-Based Status and Sharing Space
By Briar Andresen and Katherine Ilten
CMS’s David Wright has signaled that new provider-based guidance will be issued in early 2019.
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Katherine B. Ilten
Shareholder
Email: kilten@fredlaw.com
Office: 612.492.7428
Assistant: Cynthia Pierson, 612.492.7560
Overview
Experience
Articles & Presentations
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Honors & Education
Professional Activities
Overview
Katie co-chairs the firm’s Health Law Group and is a valued advisor to hospital systems, physician groups, life science companies, and aging and disability service providers. Katie draws on her wide base of knowledge and experience in health care regulatory matters to counsel her clients on internal and external allegations of non-compliance as well as strategic transactions and enterprise risk management matters. She represents clients across the country, including nationally recognized health systems as well as established and emerging closely held businesses in the health care industry.
Katie advises clients on health care compliance, fraud and abuse laws, Medicare and Medicaid reimbursement issues, government audits, Stark, anti-kickback, HIPAA, medical staff governance and disputes, internal investigations, regulatory issues in multi-state business expansion, professional licensing, and strategic affiliations and transactions. Katie views her role as being a critical thinker who can advise her clients on creative approaches as well as practical solutions and risk considerations.
Katie also serves on the firm’s Associate Development and Data Privacy and Security Committees.
Experience
REPRESENTATIVE EXPERIENCE
Hospitals and Health Systems
- Advised nationally renowned hospital in consolidation of multiple hospital campuses under one corporation, license and CMS certification number.
- Structured overhaul of medical staff bylaws and professional peer review infrastructure for multi-hospital systems.
- Represented hospital system in air ambulance joint venture and multi-state air ambulance expansion.
- Advised numerous hospitals in medical staff challenges and civil lawsuits brought by independent medical staff members.
Health Care Regulatory Defense
- Obtained favorable Minnesota Court of Appeals ruling that state agency was “arbitrary and capricious” in finding maltreatment against disability service provider.
- Successfully represented hospital in state Medicaid inpatient admissions appeal, exposing government’s faulty legal theory and resulting in state Medicaid program categorically reversing overpayment determinations for multiple third-party hospitals.
- Challenged Medicare extrapolated overpayment assessment of $3,000,000 against Texas physician practice and reduced overpayment to less than $15,000.
- Represented hospital systems in negotiations with Office for Civil Rights related to HIPAA breaches, investigations and resolution agreements.
- Architect of legal theory underlying successful motion to dismiss in False Claims Act lawsuit targeting hospital cardiac rehabilitation program.
- Conducted internal investigation of antikickback allegations brought by former employee of Fortune 500 company.
Aging and Disability Service Providers
- Represented skilled nursing facilities in challenging statements of deficiencies and civil money penalties before state agencies and Medicare Departmental Appeals Board.
- Defended personal care assistant agency in overpayment allegation by Medicaid fraud unit; matter closed with negotiated settlement amount less than 10 percent of the original overpayment amount alleged by the government.
- Advised opioid addiction treatment providers, behavioral health providers, and Medicaid waiver service providers in navigating complex state regulatory schemes during multi-state business expansion.
Articles & Presentations
Minnesota Court of Appeals Rejects “Arbitrary and Capricious” Abuse Ruling by DHS
May 23, 2017
By Sam Orbovich & Katherine B. Ilten
On April 17, 2017, the Minnesota Court of Appeals rejected a September 9, 2014, maltreatment ruling by the Minnesota Department of Human Services (DHS) against Meridian Services, a longtime trusted provider of services for persons with disabilities.
Perhaps the Maltreatment Sky is Not Falling, After All
April 5, 2017
By Sam Orbovich & Katherine B. Ilten
Recent news reports, fueled by official maltreatment intake statistics, have left the public concerned that thousands of Vulnerable Adult Act mandated maltreatment reports are going uninvestigated without good reason.
CMS Clarifies 60-Day Report and Return Rule in Final Regulation
February 12, 2016
By David M. Glaser & Katherine B. Ilten
Today CMS published a final rule detailing the duty to report and return overpayments with 60 days of their identification. The “report and return” requirement was adopted by Congress as part of the Affordable Care Act. This final rule is the first regulation from CMS interpreting the statute. The final rule makes it clear that the 60-day period does not begin to run until you have quantified the amount of the overpayment, or, when you should have quantified the overpayment had you been acting diligently. In other words, the 60-day clock does not start to run when you first discover a potential billing problem.
Medicare Providers and Suppliers Should Continue to Appeal Improper Denials, Despite Two Year Delay in Appeal Processing
January 31, 2014
By Katie B. Ilten & David M. Glaser
The Office of Medicare Hearings and Appeals recently informed a number of Medicare providers and suppliers that the already long wait until their “day in court” would get even longer.
Major Change to Time Limit on Overpayment Recovery Buried in the Fiscal Cliff
January 1, 2013
By David M. Glaser & Katherine B. Ilten
One provision in the “American Taxpayer Relief Act of 2012,” the “fiscal cliff” bill, received little attention in the press, but will have a major impact on health care organizations.
PUBLICATIONS & PRESENTATIONS
Articles
- “Major Change to Time Limit on Overpayment Recovery Buried in the Fiscal Cliff,” co-authored with David M. Glaser, FredALERT: Health, January 2013
Presentations
- “Know Your Risk: Critical Compliance Steps for HIPAA Security Risk,” LeadingAge Minnesota Institute, February 8-10, 2017
- “How to Conduct a HIPAA Risk Assessment for Dummies,” Care Providers of Minnesota, November 14, 2016
- “Abuse or Accident: Navigating the VAA,” LeadingAge Minnesota, February 2015
- “Handling Surveys and Unfavorable Statements of Deficiencies,” Care Providers of Minnesota, November 17, 2014
- “Implementing and Maintaining Compliance Programs,” Health Care Fraud & Abuse Minnesota CLE, November 3, 2015
- “Fair Housing: A Refresher Course” LeadingAge Minnesota Institute, February 7, 2014
Webinars
- “Provider-Based Status and Co-Location: New CMS Guidance and Strategic Steps for Compliance,” Fredrikson & Byron Health Law Webinar Series, June 12, 2019
- “Avoiding Unnecessary Refunds: How to Keep Payments to Which You Are Entitled,” Fredrikson & Byron Health Law Webinar Series, October 10, 2018
- “Health Law FAQs Answered,” Fredrikson & Byron Health Law Webinar Series, August 8, 2018
- “Almost Everything You Want to Know About Ancillaries,” Fredrikson & Byron Health Law Webinar Series, March 14, 2018
- “Love Letters to and from CMS: Responding to Audits and Overpayments and Making Voluntary Refunds,” Fredrikson & Byron Health Law Webinar Series, February 14, 2018
- “HIPAA: Are We Doing This Right?!,” Fredrikson & Byron Health Law Webinar Series, November 8, 2017
- “Top Health Law FAQs for Hospitals and Clinics,” Fredrikson & Byron Health Law Webinar Series, July 12, 2017
- “New Rules: MIPS, Physician Fee Schedule, Outpatient Rule and More!,” Fredrikson & Byron Health Law Webinar Series, December 14, 2016
- “Grab Bag: Hot Health Law Topics Presented in a ‘Beach-Read’ Format,” Fredrikson & Byron Health Law Webinar Series, August 10, 2016
- “Current Government Enforcement and Pitfalls in Provider-Based Billing,” Fredrikson & Byron Health Law Webinar Series, April 13, 2016
- “Lessons Learned from Recent HIPAA and Big Data Breaches,” Fredrikson & Byron Health Law Webinar Series, August 12, 2015
- “Voluntary Refunds and Internal Investigations: Tips, Tricks and Tripwires,” Fredrikson & Byron Health Law Webinar Series, August 12, 2009, July 13, 2011 and June 10, 2015
- “Grab Bag: Electronic Health Records and What Should Keep You Up at Night,” Fredrikson & Byron Health Law Webinar Series, February 11, 2015
- “Key Topics from the 2015 Medicare Physician Fee Schedule, OIG Work Plan and Hospital Outpatient Rule,” Fredrikson & Byron Health Law Webinar Series, December 10, 2014
- “Two Midnight Rule and Admission Certifications: Tips, Tricks and Traps,” Fredrikson & Byron Health Law Webinar Series, December 11, 2013 and September 10, 2014
- “Still More FAQs for Hospitals and Clinics,” Fredrikson & Byron Health Law Webinar Series, August 13, 2014
- “F&B HIPAA Training: Direct Training Session for Health Care Staff,” Fredrikson & Byron Health Law Webinar Series, September 11, 2013
- “Short Stay Update: Medicare’s New ‘Two Midnight” Rule,’” Fredrikson & Byron Health Law Webinar Series, August 22, 2013
- “Countdown to HIPAA Enforcement Date: Checklist of Last Steps for Complying with New HIPAA Regulations,” Fredrikson & Byron Health Law Webinar Series, July 10, 2013
- “RACs, ZPICs and PSCs: Practical Administrative Tips and Creative Legal Arguments,” Fredrikson & Byron Health Law Webinar Series, March 13, 2013
- “Revenge of HIPAA: What You Need to Know About the New HIPAA Regulatory Scheme,” Fredrikson & Byron Health Law Webinar Series, February 13, 2013
- “New Medicare Rules,” Fredrikson & Byron Health Law Webinar Series, December 14, 2011. December 8, 2010, and December 9, 2009
Honors & Education
EDUCATION
- University of Iowa College of Law, J.D., 2008, with High Distinction
- St. Olaf College, B.A., 2004, summa cum laude
BAR ADMISSIONS
- Minnesota, 2008
HONORS
- Minnesota State Bar Association, North Star Lawyer, 2013
- Order of the Coif, University of Iowa College of Law
- Phi Beta Kappa, St. Olaf College
- Journal of Corporation Law, Articles Editor, 2007-2008; staff member, 2006-2007
Professional Activities
PROFESSIONAL ACTIVITIES
- Member, Minnesota State Bar Association, Health Law Section
- Member, American Health Lawyers Association
COMMUNITY
- FamilyWise, Board of Directors