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Kelsey E. Fohner

Partner

Kelsey represents large health systems, individual hospitals, ambulatory surgery centers, community health providers and individual physician practices in transactional and regulatory compliance.

As outside counsel, Kelsey provides daily operational counsel to clients related to the various aspects of the health care industry. She has significant experience drafting and negotiating various agreements between hospital systems (or their related subsidiaries and affiliates) and physician groups to comply with federal and state fraud and abuse laws (notably, the Stark Law, Federal Anti-Kickback Statute, and analogous state variations). Kelsey also regularly advises clients on licensing and corporate compliance.

Kelsey draws upon her previous experience as on-site support to a large health care delivery system.

Health System Operations and Governance
  • General risk management advice, including patient consents, issues related to termination of the physician-patient relationship, and relevant state law for health care directives.
  • Facility and practitioner licensing and scope of practice requirements.
  • The Joint Commission standards for accreditation.
  • Medical staff issues, including peer review and quality review committees.
  • EMTALA related issues, including preparation of transfer agreements, advising the Medical Staff regarding its obligations and developing EMTALA policies.
  • Advising governing boards of fiduciary duties and general compliance with governing documents.
Physician-Hospital Contracting
  • Physician employment agreements, including template agreements to be used broadly across a health system.
  • Professional services agreements for exclusive and non-exclusive service lines, including radiology and pathology.
  • Call coverage agreements.
  • Administrative services agreements, including Medical Directorships and physician leadership positions.
  • Physician recruitment agreements.
  • Timeshare and office-space lease agreements.
  • Purchase agreements for physician practice acquisitions.
Licensing Compliance
  • Review of Federal and state regulatory requirements related to facility and practitioner licensing, health care transactions and Federal and state reimbursement requirements, including Medicare filings, Conditions of Participation and Conditions for Coverage, provider-based status, national accreditation requirements, related state licensure, and certificate of need (CON) laws.
Corporate Compliance and Fraud and Abuse
  • Review and preparation of corporate compliance materials and compliance programs to comply with the Health Insurance Portability and Accountability Act (HIPAA) and relevant Office for Civil Rights (OCR) requirements, as well as Guidance from the Office of Inspector General (OIG) for compliance programs.
  • Advising clients regarding compliance with the Federal Stark Law, Federal Anti-Kickback Statute, and the Civil Monetary Penalties law, including review under the beneficiary inducements prohibitions.
  • Counsel to clients regarding interpretation and application of Corporate Integrity Agreement provisions and preparation of CIA reports.
  • Review and investigation of fraud and abuse allegations, including preparation and submission of documents to the CMS Self-Referral Disclosure Protocol. 

Super Lawyers® Rising Stars, 2017-2018, 2020-2022