Published Works | Archive

Legal Manual for New York Physicians, 4th Edition, Vol. 2, Chapter 56, "Medicare Audits of Physician Claims and the Medicare Appeals Process" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., New York State Bar Association/Medical Society of the State of New York, 2014

"Partial Relief in Sight: CMS Proposes Settlement of Pending Inpatient Hospital 'Status' Appeals" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., ABA Health eSource, Vol. 11 No. 2, October 2014.

"What Are Medicare Appeals?" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., American Bar Association, 2014.

"Hospitals Must Continue Implementation of Controversial 2-Midnight Rule" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., American Case Management Association, Collaborative Case Management, Vol. 11, Issue 05, Summer 2014.

"Medicare Appeals Adjudication Delays: Implications for Healthcare Providers and Suppliers" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., The Health Lawyer, Vol. 26, No. 5, June 2014.

Jessica L. Gustafson, Esq. was quoted in "Hospital Loses ABN Appeal to Patient Based on Use of Acronym", AIS Health, May 2014.

"How Long Must We Wait? Repercussions for Health Care Providers and Suppliers of ALJ Adjudication Delays" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., AHLA Newsletter, May 2014.

"2-Midnight Rule Update: Hospitals Must Continue Implementation of the 2-Midnight Rule" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., The Health Lawyer, Vol. 26, No. 4, April 2014.

"Hospitals Brace for 'Probe and Educate' MAC Audits as Physician Documentation in Hospitals Takes on Even Greater Importance: Impact of the 2014 Inpatient Prospective Payment System ('IPPS') Final Rule on Hospital-Based Physician Documentation" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., BC Advantage, February/March 2014.

Jessica L. Gustafson, Esq. was quoted in "Report on Medicare Compliance" Vol. 23, No. 6, February 17, 2014.

"The Latest Development in Federal Health Care Audit Programs: Supplemental Medical Review Contractor Audits" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., BC Advantage, January 2014.

Jessica L. Gustafson, Esq. was quoted in "Report on Medicare Compliance", Vol. 23, No. 2, January 20, 2014.

Jessica L. Gustafson, Esq. and Abby Pendleton, Esq. were quoted in "Whacked by RAC", Hospitals & Health Networks, January 14, 2014.

"Billing for and Appealing Denials of Inpatient Hospital Services: Where Have We Been? Where Are We Now? What Does the Future Hold?" by Jessica L. Gustafson, Esq. and Abby Pendleton, Esq., ABA Health Law Section, The Health Lawyer, December 2013.

Jessica L. Gustafson, Esq. was quoted in "Report on Medicare Compliance", Vol. 22, No. 40, November 11, 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. was quoted in "Report on Medicare Compliance", Vol. 22, No. 35, 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.

"SMRC: The Latest Development in Medicare Audits" by Adrienne Dresevic, Esq. and Jessica L. Gustafson, Esq., AHRA Link, 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.

"2014 IPPS Final Rule Establishes New Requirements for Physician Documentation in Hospitals" by Jessica L. Gustafson, Esq., ABA Health Law Section Physician Issues Interest Group Member Alert, August 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., HLP Client Alert, 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.

Adrienne Dresevic, Esq., Jessica L. Gustafson, Esq., and Clinton Mikel, Esq. were featured in the Legal People section of The Detroit Legal News, June 17, 2013 edition.

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

Jessica L. Gustafson, Esq. was quoted in "Painful Side Effects: Drug Abuse Problems Evade Paltry Anti-Fraud Efforts in Medicare Part D", Modern Healthcare, April 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. was quoted in "The Problems with Audits", an article on The Recovery Audit Contractor (RAC) program, by Deborah Abrams Kaplan, Diagnostic Imaging, February 6, 2013.

Jessica L. Gustafson, Esq. and Abby Pendleton, Esq. were quoted in "Facing an Audit? Here's What You Need to Know", Diagnostic Imaging, February 6, 2013.

Jessica L. Gustafson, Esq. and Abby Pendleton, Esq. were quoted in "Putting Practices on the RAC", Physician's Money Digest, November 12, 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.

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

“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.

"Regulatory Review: Special Annual Meeting Edition" by Adrienne Dresevic, Esq. and Jessica L. Gustafson, Esq., AHRA Link, August 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, Winter 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.

"Recovery Audit Contractors and Medicare Audits: Successful Strategies for Preparing for and Defending Audits" by Jessica L. Gustafson, Esq., Journal of Health Care Compliance, September/October 2008.

"Recovery Audit Contractors and Medicare Audits: Successful Strategies for Defending Audits" by Jessica L. Gustafson, Esq., Radiology Business Journal, Vol. 3, No. 8, August 13, 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.

"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.

"DMC/WSU Joint Residency Programs: Progress Made, but Work Remains" by Jessica L. Gustafson, Esq., Michigan Medical Law Report, Vol. 3, No. 1, Spring 2007.

"The Medicare Appeals Process and Strategies for Successful Appeals" by Jessica L. Gustafson, Esq., American Health Lawyers Association, Physician Organizations, Vol. 10, Issue 1, Winter 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.

"Legal Issues Impacting Physician Practices: Providing Physical Therapy Services" by Adrienne Dresevic, Esq. and Jessica L. Gustafson, Esq., Michigan Medical Law Report, Vol. 2, No. 2, Summer 2006.

"Starting a Physician Practice in Michigan," by Jessica L. Gustafson, Esq. and Robert S. Iwrey, Esq., Michigan Medical Law Report, Vol. 2, No. 1, Spring 2006.