Kristen Pollock McDonald defends providers in False Claims Act litigation brought by federal and state agencies and qui tam whistleblowers. Her civil fraud experience involves billing, coding, medical necessity, kickbacks, eligibility, and documentation errors. Kristen defends providers in government extrapolated audits, including those initiated by UPICs, ZPICs, the OIG, and other government agencies.
She also conducts internal investigations on behalf of providers and assists providers with repayments and self-disclosures. Additionally, she conducts internal investigations associated with HIPAA/HITECH concerns and defends providers in OCR investigations of potential breaches. She also defends providers in government enforcement actions involving civil money penalties and termination.
In addition, she has extensive experience conducting health care due diligence reviews for M&A and banking and finance matters, focusing on fraud and abuse and other regulatory and compliance concerns.
Kristen routinely advises providers on fraud and abuse analyses, telemedicine services and reimbursement, compliance program development and effectiveness reviews, and EMTALA compliance, among other legal issues.
Kristen has represented hospitals/health systems; hospice, home health, skilled nursing facilities, and other post-acute care providers; medical device manufacturers and distributors; telehealth companies; diagnostic imaging; ambulance suppliers; DMEPOS; financial institutions; and private equity investors.
Kristen is a member of the American Health Lawyers Association and serves as chair of AHLA’s Health Care Liability and Litigation Practice Group.
Kristen has written and spoken extensively on health care issues, including meaningful use incentive payments and audits, ZPIC audits, government recoveries under the FCA, risk areas for post-acute care providers, and due diligence reviews.
- The George Washington University (J.D. 1998; Moot Court Board; Jessup Moot Court Competition, International Rounds Participant; Research and Writing Dean’s Fellow);
- University of California, Los Angeles (B.A. summa cum laude 1995; Phi Beta Kappa); Oxford University, England (Extension Program, 1994)
- U.S. District Courts for the Middle and Northern Districts of Georgia, and
- U.S. Courts of Appeals for the Sixth and Eleventh Circuits
- Brockway Moran sells portfolio company MD Now Holdings to Brentwood Associates
- Cardinal Health sells majority stake in NaviHealth to Clayton, Dubilier & Rice
- ProMedica Health and Welltower complete acquisition of HCR ManorCare and Quality Care properties for $4.4 billion
- Physician-owned Ambulatory Surgery Center issued favorable reconsideration decision in Medicare overpayment appeal
- Pediatric Services of America defeats False Claims Act charges
- Cardinal Health acquires rights to Lymphoseek® from Navidea Biopharmaceuticals
- Revenue cycle management company advised on HIPAA and HITECH regulatory compliance
- Health care provider defends an Office of Inspector General audit of claims
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