Published Works — Archive

"Billing for and Appealing Denials of Inpatient Hospital Services: Where have we been? Where are we now What does the future hold?" ABA Health Law Section, The Health Lawyer, by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., December 2013.

"The Latest Development in Medicare Audits: Supplemental Medical Review Contractor ("SMRC") Audits", by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., ABA Health eSource, Vol. 10, No. 2, October 2013.

Adrienne Dresevic, Esq., Jessica L. Gustafson, Esq., Robert S. Iwrey, Esq., Carey F. Kalmowitz, Esq., and Abby Pendleton, Esq. were named Attorneys of The Month by Attorney At Law Magazine and were featured on the front page and on page 16 in "Healthy Growth: The Health Law Partners Has Rapidly Become One Of The Industry's Premier Health Care Law Firms" by Katherine Bishop, Attorney At Law Magazine, Metro Detroit Edition, Vol. 2, No. 6, October 2013.

Jessica L. Gustafson, Esq. and Abby Pendleton, Esq. were quoted in "Report on Medicare Compliance", Vol. 22, No. 36, October 2013.

Jessica L. Gustafson, Esq. and Abby Pendleton, Esq. were quoted in "Claims under the microscope: Hospitals add observation units to reduce inpatient stays; costs fall, but scrutiny rises", Crain's Detroit Business, September 2013.

"CMS Publishes 2014 IPPS Final Rule: Revises Reimbursement Criteria Related To Patient Status" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Health Lawyers Weekly, August 23, 2013.

"CMS Publishes 2014 Inpatient Prospective Payment System ("IPPS") Final Rule: CMS Payment Policies Related to Patient Status Revised" by Jessica L. Gustafson, Esq. and Abby Pendleton Esq., August 2013.

Jessica L. Gustafson, Esq. and Abby Pendleton, Esq. were quoted in "Reaping the Rewards of Experience: The DOs and DON'Ts for Filing Claim Appeals", Medicare Compliance, Vol. 22, No. 27, page 2 & 3, July 29, 2013.

Jessica L. Gustafson, Esq. and Abby Pendleton, Esq. were quoted in "CPR Refusal Highlights Risk of Overly Strict Policies", Healthcare Risk Management, Vol. 35, No. 5, May 2013.

"CMS Acquiesces to Hospital Pressure, Allows Part B Billing of Hospital Services Following Part A Denial of Inpatient Hospital Claims for Medical Necessity: Is It Enough?" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., ABA Health eSource, Vol. 9, No. 7, March 2013.

Jessica L. Gustafson, Esq. and Abby Pendleton, Esq. were interviewed and quoted in "Facing an Audit? Here's What You Need to Know", an article on The Recovery Audit Contractor (RAC) program, by Deborah Abrams Kaplan, Diagnostic Imaging, February 6, 2013.

Adrienne Dresevic, Esq. and Abby Pendleton, Esq. were interviewed and featured in the December 4, 2012 issue of Motion Magazine in an article titled, "In Good Health".

Jessica L. Gustafson, Esq. and Abby Pendleton, Esq. were interviewed and quoted in the November 12, 2012 issue of Physician's Money Digest in an article titled, "Putting Practices on the RAC".

Abby Pendleton, Esq. was interviewed and quoted in the article "Audits Look for Medicare Overbilling", which was featured in Crain's Detroit Business on November 12, 2012.

Abby Pendleton, Esq. was interviewed and quoted in the article "Hospitals Brace for Audits of Short-Stay Admissions", which was featured in Crain's Detroit Business on November 5, 2012.

"CLIENT ALERT: Viewing The Recent OIG Company Model Advisory Opinion For What It Truly Is: Meaningful Guidance That Must Be Incorporated Into These Arrangements (But Certainly Not the Death Knell to All Company Models Across the Country)" by Adrienne Dresevic, Esq., Carey F. Kalmowitz, Esq., and Abby Pendleton, Esq.

"OIG Advisory Opinion 12-06: Insightful Guidance from the OIG For Structuring Company Model Arrangements" by Kathryn Hickner-Cruz, Esq., Carey F. Kalmowitz, Esq., and Abby Pendleton, Esq., ABA Health eSource, June 2012.

"Proposed Meaningful Use Stage 2 -- What it Means to the Anesthesia and Pain Communities" by Stephanie P. Ottenwess, Esq. and Abby Pendleton, Esq., Communique, Spring 2012.

"Anesthesia Practices Should Prepare for More Audit Activity" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Communique, Winter 2011.

"Sleeping Giants: Compliance in the Age of Electronic Medical Records" by Jessica L. Gustafson, Esq., Abby Pendleton, Esq., and Ranjan Sachdev, MD, MBA, CHC, Association of Healthcare Internal Auditors New Perspectives, Winter 2011.

"The Future of the Recovery Audit Contractor Program" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., ABA eSource, August 2011

"Compliance Can Be Tricky in the Age of Electronic Medical Records" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Spring 2011.

"The Recovery Audit Contractor ("RAC") Program: What Can Laboratories and Pathologists Expect?" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., G-2 Compliance Report, February 2011.

"RAC Program Proposed Rule Published" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Winter 2011.

"The OIG's New Roadmap on Avoiding Fraud and Abuse" by Stephanie P. Ottenwess, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Winter 2011.

“Proposed HIPAA Regulations: What Physician Practices Need to Know” by Jessica L. Gustafson, Esq., Stephanie Ottenwess, Esq., and Abby Pendleton, Esq., Michigan Medical Law Report, Fall 2010.

"Compliance Corner: Focus on Compliance" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Communique, Fall 2010.

"Health Care Reform Measures, Increased Audit Scrutiny, and More Reasons Why Compliance Programs Matter" by Kathryn Hickner-Cruz, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 6, No. 2, p. 12, Summer 2010.

"The Anesthesia Community Must Be Prepared for Increased Audit Activity by RACS and Others" by Abby Pendleton, Esq., Communique, Spring 2010.

"AHLA Deciphering Codes: Fraud & Abuse for Coders and Coding Insight for Healthcare Lawyers", a chapter in the AHLA/AAPC Coding Manual by Abby Pendleton, Esq., published in 2010.

"Breach Notification Final Rule" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., The Communique, Winter 2010.

"HIPAA Enforcement Strengthened, Penalties Increased" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 5, No. 4, Winter 2010.

"The RAC Program: What Can Radiology Providers Expect as RACs Begin Auditing?" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Radiology Management, November/December 2009.

"Physicians Can Choose to Opt Out of Medicare Participation" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 5, No. 3, Fall 2009.

"HITECH in a High Tech Era" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Communique, Fall 2009.

"What Anesthesiologists and Pain Management Physicians Need To Know About The RAC Program" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Communique, Summer 2009.

"Medicare Eases Rule on Termination of Provider Medical Records Review" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 5, No. 1, Spring 2009.

"Recovery Audit Contractors And Medicare Audits: What Can Hospitals and Health Systems Expect as the RAC Program Expands Nationwide?” by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., American Health Lawyers Association, Hospitals and Health Systems Practice Group Member Briefing, January 2009.

"Get Ready -- Recovery Audit Contractors Are Coming to Michigan" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 4, No. 4, January 2009.

"RAC to the Future: What Can Medicare Providers and Suppliers Expect from the Recovery Audit Contractor Program?" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., The Health Lawyer, The ABA Health Law Section, Vol. 21, No. 2, December 2008.

"The RACs Are Coming - Are You Ready?" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., The RAP Sheet, American Health Lawyers Association, December 2008.

"Recovery Audit Contractors and Medicare Audits: Successful Strategies for Defending Audits" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Caring, National Association of Home Care and Hospice, November 2008.

"Planning for Compliance" by Adele P. Jorissen, Esq. and Abby Pendleton, Esq., Anesthesia Business Consultants Communique, Fall 2008.

"Can Medicare Take My Money? What the One-Time Notification Means" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 4, No. 2, Summer 2008.

"Compliance Corner: OIG Workplan 2008" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Anesthesia Business Consultants Communique, Spring 2008.

"OIG Work Plan 2008: What Can Providers Expect in 2008?" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 4, No. 1, Spring 2008.

"Is Medicare Being Billed the Right Way? Here's How to Avoid the Risks" by Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 3, No. 4, Winter 2008.

"Get Ready: RACs May be Nationwide Sooner than Expected!" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., HCCA Compliance Today, Vol. 9, No. 10, October 2007.

"Get Ready for Increased Nationwide Medicare Audit Activity" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 3, No. 3, Fall 2007.

"Legal Issues Impacting Physician Recruitment Relationships" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 2, No. 4, Winter 2007.

"What All Physicians Need to Know About the Proposed Changes to the Medicare Physician Fee Schedule" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 2, No. 3, Fall 2006.

"3 Cost-Effective Compliance Tips to Jump Start Your Compliance Efforts" by Abby Pendleton, Esq., Communique, Fall 2006.

"Prescribing Controlled Substances: What Every Physician Should Know" by Robert S. Iwrey, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 2, No. 2, Summer 2006.

"The New Medicare Part A and Part B Appeals Process" co-authored by Abby Pendleton, Esq., Health Law Handbook 2006, Part I, Chapter I, 2006.

"The Michigan Social Security Number Privacy Act, New Whistleblower Provisions of the Michigan Medicaid False Claims Act and More" by Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 2, No. 1, Spring 2006.

"Billing: Three Key Compliance Tips that Every Physician Should Implement" by Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 1, No. 4, pg. 5 & 10, Winter 2005.

"Compliance Auditing: Three Key Issues That Every Physician Should Consider" by Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 1, No. 3, Fall 2005.

"The New Medicare Appeals Process" by Abby Pendleton, Esq., The Health Lawyer, The ABA Health Law Section, Vol. 17, No. 3, June 2005.

"Third-Party Payor Audits: The Impact on Anesthesia Groups" by Abby Pendleton, Esq., Anesthesia Business Consultants Communique, Fall 2004.

"Third-Party Payor Audits: Impact on Physician and Healthcare Provider Clients" by Abby Pendleton, Esq., Laches, July 2004.

"Medicare Appeal and Recovery Reforms under the Medicare Prescription Drug, Improvement and Modernization Act of 2003" by Abby Pendleton, Esq., The Health Lawyer, The ABA Health Law Section, March 2004.

"Have you Engaged in Compliance Activities Lately?" by Robert S. Iwrey, Esq. and Abby Pendleton, Esq., MSA Ventilator, December 2003.

"Final HIPAA Security Rule Allows Greater Flexibility" by Abby Pendleton, Esq., The Health Lawyer, The ABA Health Law Section, April 2003.

"New HIPAA Privacy Guidance Reduces ASC Fears" by Abby Pendleton, Esq., FASA Update: Journal of the Federated Ambulatory Surgery Association, Volume XX, Number 1, January/February 2003.

"Proactive Compliance as an Audit Defense Strategy” by Robert S. Iwrey, Esq. and Abby Pendleton, Esq., The Ventilator, January 2002.

"Cpt 2000: Pain Management Coding Compliance" by Abby Pendleton, Esq., Anesthesia Business Consultants Communique, Winter 2000.

"OIG Softens its Overall Approach in Releasing the Final Compliance Guidance for Individual and Small Group Physician Practices" by Robert S. Iwrey, Esq. and Abby Pendleton, Esq., The Health Lawyer, The ABA Health Law Section, October 2000.

"OIG Issues Draft Compliance Guidance for Individual and Small Group Physician Practices" by Robert S. Iwrey, Esq. and Abby Pendleton, Esq., Health Care Weekly Review, July 19, 2000

"OIG Issues Draft Compliance Guidance for Individual and Small Group Physician Practices" by Robert S. Iwrey, Esq. and Abby Pendleton, Esq., The Health Lawyer, The ABA Health Law Section, June 2000.

"Hospice Providers are Well Advised to Address OIG Identified Hospice Risk Areas" by Abby Pendleton, Esq., Health Care Weekly Review, February 2000.

"OIG Issues Special Advisory Bulletin on Gainsharing Arrangements" by Abby Pendleton, Esq., Anesthesia Business Consultants Communique, Fall 1999.

"Continuing Education is Key to Compliance" by Abby Pendleton, Esq., Anesthesia News, November 1999.

"OIG Issues Compliance Guidance for the Hospice Industry and Medicare + Choice Organizations" by Abby Pendleton, Esq., The Health Lawyer, The ABA Health Law Section, October 1999.

"HCFA Issues Final Rule on Medical Direction" by Abby Pendleton, Esq., Anesthesiology News, November/December 1998.

"HIPAA Security Workbook and Toolkit" by Abby Pendleton, Esq., FASA.

"Anesthesia Time: Compliance Tips" by Abby Pendleton, Esq., Anesthesia Business Consultants Communique.

"HIPAA Security Workbook and Toolkit" by Abby Pendleton, Esq., United Communications Group.