Overview
David helps clinics, hospitals, and other health care entities negotiate the maze of health care regulations, providing advice about strategy, reimbursement and compliance.
David is a shareholder in Fredrikson’s Health Law group and co-founded its Health Care Fraud & Compliance group. He has considerable experience in health care regulation and litigation, including voluntary disclosures, criminal and civil fraud investigations, overpayments and reimbursement disputes.
David’s goal is to explain the government’s enforcement position, and to analyze whether this position is supported by the law or represents government overreaching.
David is a frequent guest on RAC Monitor’s “Monitor Mondays,” and you may read his blog at Orthopedics Today. He has given speeches in 36 states.
Services
Credentials
Education
- University of Michigan Law School, J.D., 1992, cum laude
- University of Chicago, B.A., Public Policy, 1988, with honors
Admissions
- Minnesota, 1992
- Iowa, 1998
- U.S. District Court, 1992
Recognition
- The Best Lawyers in America, Health Care Law, 2022-present
- North Star Lawyer, Minnesota State Bar Association, 2018
- National Merit Scholar, Phi Beta Kappa
Civic & Professional
Professional Activities
- Association for Healthcare Denial and Appeal Management (AHDAM), Advisory Board Member, 2020-present
- Fredrikson & Byron, P.A., Board of Directors, 2009-2013
Community
- Orthopedics Today Business of Orthopedics, Editorial Board Member
- Gillette Children’s Specialty Healthcare, Board Member
News & Insights
News
Speaking Engagements
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Legal Updates
Publications & Presentations
Orthopedics Today: Presented at 11 conferences, topics include: Practice Management; Umbrella Mergers: Concepts & Benefits; Joint Business Ventures: Practice Partnerships That You Can Take to the Bank; The Legal Ramifications of Physician-Owned Ancillary Services; and Gain Sharing for the Orthopedic Surgeon: What’s Legal and What’s Not.
Health Care Compliance Association (HCCA): Presented at more than 25 conferences, topics include: Identifying Overpayment Liability in Physician Practices; Arguments to Avoid/Defend Overpayments; Recent Developments in Voluntary Disclosure; Document, Document, Document and Other Medicare Myths; Criminal and Civil Liability for Overpayments: Correcting Mistakes or Committing Fraud; Voluntary Disclosures: Do I Really Need to Give This Back?; and Creative Defenses to Potential Overpayments/False Claims.
American Association of Orthopaedic Executives (AAOE): More than 18 presentations. Topics include: Relationships with Other Groups, Hospitals and Drug and Device Companies: What You Can and Can’t Do; Not Everything is Illegal: Tips to Improve the Bottom Line; Fighting Back Against Insurance Carriers; Medicare Myths: Common Misperceptions About Medicare Billing Rules; A RAC: Audit of Mass Destruction?; Stump the Lawyer: Practical Answers to Common Orthopedic Legal Issues; Joint Venturing Without Going to the Joint; Audits and Appeals: Challenging Medicare and Other Payors; and Health Care Pricing: Establishing Fees, Discounts, Charging Interest, Out-of-Network Arrangements and Other Issues.
The American Health Lawyers Association (AHLA): Presented at 5 conferences, topics include: Medicare Myths and Voluntary Disclosure; Medicare Myths: Common Misperceptions About Billing Rules; and Voluntary Disclosures: Do I Really Need to Give This Back?
Oncology Societies: More than 15 presentations at state and national oncology meetings, topics include: What Should Keep me Awake at Night: Often Overlooked Issues; Dear David: Relationship Advice from a Lawyer; Medicare Myths: Not Everything the Government Says is True; Legal Makeover: How Do It Yourself Beats Government Assistance; Audit Risk Factors: What Triggers an OIG Audit and How You Should Respond; Medicare Myths: Law or Not; Medicare Myths: Stark Laws; and Avoiding Ancillary Angst and Other Compliance Considerations.
Anthroscopy Association of North America (AANA): Presented at over nine conferences, topics include: Practice Management: Update on Coding Ancillary Services and the New Stark Laws; Surviving a Government Audit Successfully; Addressing Audits: Conventional Wisdom is Often Wrong; Optimizing Your Practice Through New Office Coding Management Strategies; Using Ancillaries to Increase Practice Revenue; Laws Governing Ancillary Services; Joint Venturing Without Going to the Joint; and What Do I Do if There’s an Audit?
Medical Group Management Association (MGMA): Presented at over 25 national and state conferences, topics include: Medicine Compliance; Medicare Myths: Common Misperceptions about Billing Rules; Voluntary Disclosures; More Myth Management: Fighting Back Against Insurers and Investigators; Stark Reality: Issues for Oncology Practices; Not Everything is Illegal: Legal Tips to Improve the Bottom Line; Audit Risk Factors: What Triggers an OIG Audit; Dealing with the Government and Private Payers: How to Anticipate and Respond to Audits and Inquiries; Coding Review 101; Avoiding Arson While Igniting Innovation: ‘Hot’ Legal Topic; Dear David: Relationship Advice from a Lawyer; Do I Need to Worry About This? What Coders Need to Know About Conducting Documentation Reviews; Can I Keep That? Gifts, Gratuities and Graft; and Embezzlement 101
Midwest Medical Insurance Company (MMIC): Presented more than 20 speeches/webinars on topics including compliance and risk management
Other Publications & Presentations
Read RAC Monitor articles
“Revenue Cycle: Incident to Billing,” Complete Healthcare Compliance Manual, 2021 and 2022 Editions
“Revenue Cycle: The 60-Day Rule—Medicare and Medicaid Overpayments,” Complete Healthcare Compliance Manual, 2021 and 2022 Editions
Tips for Interviews During Internal Investigations Webinar, Fredrikson & Byron Health Law Webinar Series, September 11, 2024
Health Law FAQ: Practical Answers to Common Questions Webinar, Fredrikson & Byron Health Law Webinar Series, August 14, 2024
Mistakes We’ve Made: How to Not Screw Up, a Health Law “M&M” Webinar, Fredrikson & Byron Health Law Webinar Series, July 10, 2024
“Number of Noncompetes Is Likely to Decrease,” Orthopedics Today, May 21, 2024
Tips for Dealing with Insurers, Surveyors, MACs and the Government, Fredrikson & Byron Health Law Webinar Series, April 10, 2024
Mitigating Risk: Regulatory Requirements and Guidance, American Health Law Association's Speaking of Health Law, April 2, 2024
Relationship Advice for the Lawlorn, Fredrikson & Byron Health Law Webinar Series, February 14, 2024
The Annual Regulatory Update, Fredrikson & Byron Health Law Webinar Series, December 13, 2023
Pricing and Pixels, Fredrikson & Byron Health Law Webinar Series, November 8, 2023
Common Misunderstandings About Legal Privileges, Fredrikson & Byron Health Law Webinar Series, September 13, 2023
The Annual FAQ Session, Fredrikson & Byron Health Law Webinar Series, August 9, 2023
What You Need to Know About Ancillaries, Fredrikson & Byron Health Law Webinar Series, July 12, 2023
Refunding Wisely: Avoiding Doing the Right Thing the Wrong Way, Fredrikson & Byron Health Law Webinar Series, April 12, 2023
The End of the PHE, Fredrikson & Byron Health Law Webinar Series, March 8, 2023
Health Care Pricing, Fredrikson & Byron Health Law Webinar Series, February 8, 2023
'Incident To,' Shared Visits, Residents and Medical Students, Fredrikson & Byron Health Law Webinar Series, January 18, 2023
2023 Regulatory Update, Fredrikson & Byron Health Law Webinar Series, December 14, 2022
Health Law Basics: Part Two, Fredrikson & Byron Health Law Webinar Series, November 9, 2022
Innovative Business Models for Health Care Organizations, Fredrikson & Byron Health Law Webinar Series, September 14, 2022
The Annual FAQ Session, Fredrikson & Byron Health Law Webinar Series, August 10, 2022
Dispelling Widespread Misunderstandings of the Two-Midnight Rule, Fredrikson & Byron Health Law Webinar Series, July 13, 2022
Legal Issues Associated with Medical Coding and Billing, Fredrikson & Byron Health Law Webinar Series, May 11, 2022
Surprise Reprise: No Surprises Act Revisited, Fredrikson & Byron Health Law Webinar Series, April 13, 2022
Responding to Audits and Investigations, Fredrikson & Byron Health Law Webinar Series, March 9, 2022
The 2022 Regulatory Update: Vaccines, Shared Visits, Co-mingled Space and More, Fredrikson & Byron Health Law Webinar Series, December 8, 2021
The “No Surprise Billing” Act: As Clear as We Can Make It, Fredrikson & Byron Health Law Webinar Series, November 10, 2021
The ABCs (and XYZs) of ASCs, Fredrikson & Byron Health Law Webinar Series, June 9, 2021
Physician Compensation in Hospital Systems and Clinics, Fredrikson & Byron Health Law Webinar Series, May 10, 2021
Understanding and Protecting Legal Privileges, Fredrikson & Byron Health Law Webinar Series, February 10, 2021
Interoperability, Provider Relief Funds and More Stark/Anti-Kickback!, Fredrikson & Byron Health Law Webinar Series, January 13, 2021
The Annual Regulatory Update, Fredrikson & Byron Health Law Webinar Series, December 9, 2020
Responding to 'But I heard that’s illegal!', Fredrikson & Byron Health Law Webinar Series, October 14, 2020
COVID-19 Grab Bag, MSBA Health Law Section Webinar, September 18, 2020
Health Law FAQ: COVID-19 and More, Fredrikson & Byron Health Law Webinar Series, August 12, 2020
Health Care Pricing, Fredrikson & Byron Health Law Webinar Series, May 13, 2020
COVID-19 Interim Final Rule: The Sequel, Fredrikson & Byron Health Law Webinar Series, May 6, 2020
“Tips for Conducting Interviews During Internal Investigations,” Journal of Health Care Compliance, Volume 22, Number 2, March-April 2020
COVID-19 Regulatory Update: The Latest on Waivers, Fredrikson & Byron Health Law Webinar Series, April 3, 2020
Fredrikson & Byron’s Health Law FAQs on COVID-19—What We Know as of March 20, 2020, Fredrikson & Byron Health Law Webinar Series, March 20, 2020
A Practical Guide to Co-Management/Gainsharing/Shared Savings Arrangements and CMS’s Episode-Based Payment Initiatives, Fredrikson & Byron Health Law Webinar Series, March 11, 2020
Regulatory Update, Fredrikson & Byron Health Law Webinar Series, December 11, 2019
Health Law Grab Bag: FAQs for Hospitals and Clinics, Fredrikson & Byron Health Law Webinar Series, October 16, 2019
What to Do When ICE Shows Up at Your Clinic or Hospital, Fredrikson & Byron Health Law Webinar Series, September 11, 2019
Making Sense of the Medicare Manuals, Fredrikson & Byron Health Law Webinar Series, August 14, 2019
Interacting with Government Agents and Other Officials, Fredrikson & Byron Health Law Webinar Series, July 10, 2019
Tips for Conducting Employee Interviews During Internal Investigations, Fredrikson & Byron Health Law Webinar Series, February 13, 2019
2019 Medicare Physician Fee Schedule, OPPS and IPPS Final Rules and Other News, Rules and More, Fredrikson & Byron Health Law Webinar Series, December 12, 2018
Avoiding Unnecessary Refunds: How to Keep Payments to Which You Are Entitled, Fredrikson & Byron Health Law Webinar Series, October 10, 2018
Stark 101, Fredrikson & Byron Health Law Webinar Series, September 12, 2018
Health Law FAQs Answered, Fredrikson & Byron Health Law Webinar Series, August 8, 2018
Preserving Privilege in Investigations, Fredrikson & Byron Health Law Webinar Series, July 11, 2018
’Incident To’, Shared Visits and Other Encounters with Non-Physician Professionals, Fredrikson & Byron Health Law Webinar Series, May 9, 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, Law Webinar Series, February 14, 2018
2018 Medicare Regulatory Update, Health Law Webinar Series, December 13, 2017
Health Law 101, Health Law Webinar Series, October 18, 2017
Compliance Check-up, Health Law Webinar Series, September 11, 2017
Top Health Law FAQs for Hospitals and Clinics, Health Law Webinar Series, July 12, 2017
Physician Compensation Issues: Why “Survey Says?!” May Be Totally Wrong and More, Health Law Webinar Series, May 10, 2017
New Rules: MIPS, Physician Fee Schedule, Outpatient Rule and More!, Health Law Webinar Series, December 14, 2016
Health Law 101, Health Law Webinar Series, October 13, 2016
Grab Bag: Hot Health Law Topics Presented in a ‘Beach-Read’ Format, Health Law Webinar Series, August 10, 2016
Voluntary Refunds: The 60 Day Rule and More, Fredrikson & Byron Health Law Webinar Series, June 8, 2016
What Hospitals, Physicians, Therapists and SNFS Need to Know about Medicare’s Comprehensive Joint Replacement Program and Gainsharing Too, Fredrikson & Byron Health Law Webinar Series, March 2, 2016
Co-Author with Katherine Ilten, “CMS Clarifies 60-Day Report and Return Rule in Final Regulation,” FredNEWS: Health Care, February 2016
Health Care Pricing: Establishing Fees, Discounts, Charging Interest & Other Issues, Fredrikson & Byron Health Law Webinar Series, February 10, 2016
Effectively Responding to Audits & Investigations, Minnesota HomeCare Association (MHCA), November 11, 2015
The New World Order According to CMS, Healthcare CXO Summit, Las Vegas, NV, October 19, 2015
Update-Healthcare Compliance, Midwest Oncology Practice Society (MOPS), September 19, 2015
Voluntary Refunds and Internal Investigations: Tips, Tricks and Tripwires, Fredrikson & Byron Health Law Webinar Series, June 10, 2015
What Hospitals and Clinics Need to Understand About Ancillaries, Fredrikson & Byron Health Law Webinar Series, March 11, 2015
Peer Review in the Clinic, Fredrikson & Byron Health Law Webinar Series, January 14, 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, September 10, 2014
“Private Insurance Audits: Rarely Sighted But Increasing,” RAC Monitor, August 20, 2014
Still More FAQs for Hospitals and Clinics, Fredrikson & Byron Health Law Webinar Series, August 13, 2014
Identifying Overpayment Liability in Physician Practices, Florida Hospital Association’s 11th Annual Health Care Corporate Compliance Education Retreat, June 20, 2014
“Do the MACs Need Probe and Educate Audits”,” RAC Monitor, June 19, 2014
“CGI Form Letter Provides Forum,” RAC Monitor, May 15, 2014
“Risk of Trusts Data,” RAC Monitor, April 17, 2014
“Drawing Conclusions from the Record, Draws Contention,” RAC Monitor, April 3, 2014
“Ding Dong, the RACs are Dead? Don’t Get Your Hopes Up,” RAC Monitor, March 20, 2014
Co-Author with Katie B. Ilten, “Medicare Providers and Suppliers Should Continue to Appeal Improper Denials, Despite Two Year Delay in Appeal Processing,” FredALERT: Health, January 2014
Two Midnight Rule, Physician Fee Schedule and Other New Medicare Rules for 2014, Fredrikson & Byron Health Law Webinar Series, December 11, 2013
PRRB—The Appeals, Healthcare Financial Management Association, Minneapolis, November 14, 2013
Compliance Plans Revisited, Fredrikson & Byron Health Law Webinar Series, October 9, 2013
Short Stay Update: Medicare’s New ‘Two Midnight Rule', Fredrikson & Byron Health Law Webinar Series, August 22, 2013
Health Care Pricing: Establishing Fees, Discounts, Charging Interest, Out of Network arrangements and Other Issues, Fredrikson & Byron Health Law Webinar Series, August 14, 2013
Criminal and Civil Liability for Overpayments: Creative Defenses to Potential Overpayments/False Claims, American Bar Association, 23rd Annual National Institute on Health Care Fraud, Miami Beach, FL, May 17, 2013
“New CMS Ruling and Proposed Rule on Inpatient/Outpatient Claims,” FredNEWS: Health Law, March 15, 2013
RACs, ZPICs and PSCs: Practical Administrative Tips and Creative Legal Arguments, Fredrikson & Byron Health Law Webinar Series, March 13, 2013
Presenter, Effectively Responding to Government Audits and Investigations, Aging Services of Minnesota Institute “Expanding the Possibilities,” February 6-8, 2013
“Major Change to Time Limit on Overpayment Recovery Buried in the Fiscal Cliff,” FredNEWS: Health Law, January 1, 2013
Imaging Round-Up: What You Need to Know to Provide Imaging and Get Paid for It, Fredrikson & Byron Health Law Webinar Series, September 12, 2012
Why Documentation Deficiencies Do NOT Automatically Create an Overpayment, Fredrikson & Byron Health Law Webinar Series, August 8, 2012
Medicare Refunds and Reporting Overpayments, Washington State Medical Oncology Society, May 11, 2012
Challenging Short Stay Denials: The Arguments RACs Don’t Want You to Know, Fredrikson & Byron Health Law Webinar Series, May 9, 2012
Understanding Medicare’s Supervision, Signature and Order Policies in Clinic and Hospital Settings, Fredrikson & Byron Health Law Webinar Series, April 11, 2012
Compliance Training, Fredrikson & Byron Health Law Webinar Series, March 14, 2012
Innovations in Physician Relationships, Health Law Webinar In-House Counsel Series: Anticipate Issues and Solve Problems for Your Organization, November 9, 2011
Creative Approaches for Interacting with the Government, Health Law Webinar In-House Counsel Series, October 12, 2011
Physician Relationships with Drug and Device Companies, Fredrikson & Byron Health Law Webinar Series, September 14, 2011
Overpayments and Voluntary Disclosures: Staying Compliant Without Paying More Than the Law Requires, Fredrikson & Byron Health Law Webinar Series, July 13, 2011
Health Care Pricing: Establishing Fees, Discounts, Charging Interest and Other Issues, Fredrikson & Byron Health Law Webinar Series, June 8, 2011
Co-Author with Jesse A. Witten, “The Government’s Investigation of Medicare Billing for ICDs is Based on a Flawed Legal Premise,” BNA’s Health Care Fraud Report (reproduced with permission), June 1, 2011
Antitrust and Health Care Consolidation, Fredrikson & Byron Health Law Webinar Series, March 9, 2011
New Medicare Rules, Fredrikson & Byron Health Law Webinar Series, December 8, 2010
ACO: What is an Accountable Care Organization and Why Should I Care?, Fredrikson & Byron Health Law Webinar Series, October 13, 2010
Navigating Medicare Enrollment and Claim Forms: How Routine Events Can Get You Kicked Out of Medicare, Fredrikson & Byron Health Law Webinar Series, September 8, 2010
Compliance Training: Invite Your Staff to Listen In, Fredrikson & Byron Health Law Webinar Series, February 10, 2010
Clinical Co-Management Agreements. How Physicians Can Be Compensated for Improving Hospital Efficiency, Fredrikson & Byron Health Law Webinar Series, November 11, 2009
Refunds and Voluntary Disclosures: Why You May Not Need to Turn Yourself In, Fredrikson & Byron Health Law Webinar Series, August 12, 2009
Health Care Pricing: Establishing Fees, Discounts, Charging Interest, and Other Issues, Fredrikson & Byron Health Law Webinar Series, April 8, 2009
How Rural Hospitals and Clinics Can Join to Treat Cancer, Heart Disease, and Surgery Centers, Fredrikson & Byron Health Law Webinar Series, March 11, 2009