Kate Bowles draws upon her in-depth litigation experience and background as a Registered Nurse to bring deep industry knowledge and expertise when representing healthcare providers. Focusing on investigation and enforcement of Medicare/Medi-Cal Fraud and Abuse, Stark Law, Anti-Kickback Statute, business and reimbursement litigation, and white-collar defense, Kate uses her first-hand understanding of the challenges faced by hospitals, surgery centers and individual providers to achieve exceptional results.
Diversity of Provider Clients
Kate’s experience encompasses all aspects of healthcare, including traditional healthcare systems and emerging groups in the outpatient sector, such as surgery centers, telehealth providers and substance use treatment facilities. Kate handles trial, mediation and arbitration of disputes with a variety of payors from commercial to employer to Government. Representing a diversity of providers allows Kate to effectively evaluate the motivations of various players within the healthcare industry and take advantage of emerging trends.
Focus on Prevention
Kate also brings to her practice a focus on compliance and prevention of disputes and regularly works with attorneys in Nelson Hardiman’s transactional, regulatory and finance departments to provide a full-service approach to healthcare provider clients. Payors are becoming increasingly focused on whether healthcare providers have a robust and functioning compliance program – and if not – ensuring that one is put in place following litigation through Corporate Integrity Agreements (CIAs). In this era, it is ever-more important for healthcare providers take a “big picture” approach to preventing litigation.
Life Outside the Firm
The perseverance and resolve in Kate’s healthcare law practice is reflected in her time volunteering to teach students in healthcare and legal programs about key “law and policy” drivers that have a real, practical effect on their anticipated practice area. Kate is an avid traveler, runner, yogi and enjoys being outdoors and raising her two daughters.
Accolades
Katherine has been recognized by Super Lawyers Southern California “Rising Star” 2018 – 2020 and by Super Lawyers Top Women Lawyers 2018 – 2020 . Katherine was recognized by The Best Lawyers in America “Ones to Watch ” for Healthcare Law 2021.
False Claims Act Successfully defended nationwide hospital system in multiple suits concerning healthcare fraud, including federal claims resulting from allegations of improper hospital admission through the emergency room in contravention of Medicare regulations and a separate matter involving allegations of providing unlicensed and unnecessary care for substance use disorders. In a matter involving another hospital system, successfully undermined whistleblower’s theory of the case concerning improper 5150 inpatient psychiatric holds to clear patients from local skilled nursing facilities and rehabilitation centers. health/substance abuse.
Stark and Anti-Kickback Obtained dismissal from civil conspiracy complaint and cleared client as a potential target of a criminal investigation of a large-scale workers’ compensation scheme involving over 70 parties, including California hospitals, device companies, pharmacies, marketers, and physicians.
California Hospital Pricing and Billing Advice Created a proprietary checklist of key billing and pricing authorities for 5-hospital systems in California, which can be implemented by hospital administrators to help identify and resolve areas of non-compliance.
Reimbursement Disputes Regularly represent healthcare providers in negotiating overpayment, recoupment and underpayment allegations, including all the way through trial with large-scale commercial insurance payors.
Ambulatory Surgery Center (ASC) Compliance Regularly advise and perform transactional work for surgery centers, surgeons and anesthesia providers to ensure compliance issues ranging from Stark, Anti-kickback, Corporate Practice of Medicine Concerns and Labor/Employment concerns.
Unfair Competition Litigation Successfully defended owner and four surgeons affiliated with a Southern California multi-specialty surgery center group in a lawsuit concerning a purported breach of confidentiality agreements, unfair competition and kickback allegations lodged by a competing surgery center. In a separate matter involving two surgery centers in Northern California, successfully defended anesthesia providers from enforcement of non-competition agreements purportedly signed with the prior anesthesia group at those centers.
Coronavirus (COVID-19) Resources Provided multiple clients with tools and documents needed in response to emergency rule changes put in place by the Government and commercial payors.
Provider Acquisitions Represent healthcare providers including physician practices, home health agencies and others in the course of acquisitions, mergers, joint ventures and other arrangements.
Workers’ Compensation Handle large-scale workers’ compensation lien resolutions to ensure compliance with recent updates in California Labor Code requirements and provide ongoing legal advance with respect to claims handling, settlements, and collection of liens.
White Collar Criminal Defense Obtained case dismissal on behalf of Medi-Cal physician overseeing another physician on probation from the Medical Board of California – physician client was fully cleared of all wrongdoing. In a separate matter, represented former marketer through successful plea in body-brokering allegation concerning substance use treatment.
Provisional and Post-Judgment Remedies Represent large Southern California Medi-Cal hospital in connection with pre- and post-judgment collections efforts, including two successful negotiations and settlements in 2020. In a separate matter, successfully prevented temporary restraining order (TRO) and writ of possession from being entered against former administrator of substance use treatment facility in response to allegations of property theft and misappropriation of trade secret information.
Substance Use Treatment Industry Represent substance use treatment disorder facilities, outpatient treatment programs and sober living homes in connection with Government investigations and civil wrongful death litigation.
DEA Controlled Substances Regulatory and Compliance Advice Engaged with physician medical director at radiology facility to implement DEA-compliant policies and procedures for dispensing and treating patients with controlled substances and to put in place a system of auditing for compliance on a going forward basis.
Cannabis Class Action Litigation Obtained favorable outcome for physician accused of providing medical marijuana prescriptions without adequate evaluation of patients’ underlying conditions.
HEADLINES
Nelson Hardiman Attorneys Recognized as Super Lawyers’ 2021 Southern California Rising Stars
January 28, 2021
November 11, 2020
Inaugural Edition of Best Lawyers: Ones to Watch Recognizes Two Nelson Hardiman Attorneys
August 20, 2020
MEDIA MENTIONS
November 11, 2020
Inaugural Edition of Best Lawyers: Ones to Watch Recognizes Two Nelson Hardiman Attorneys
August 20, 2020
ASC, anesthesia provider relationships risk violating anti-kickback laws — 3 insights
December 5, 2018
PUBLICATIONS
CARES Act “Provider Relief Fund” – Round Two – Follow these Steps for a Second Payment
April 29, 2020
April 20, 2020
CARES Act “Provider Relief Fund” Makes Medicare Part A and B Payments to Providers
April 13, 2020
SPEAKING ENGAGEMENTS
Pepperdine University School of Bioethics Law Class
Feb 24, 2021
Laws Effecting Anesthesia Practice
Oct 19, 2020
Legal Insights for the Future of Anesthesia Practice
Aug 18, 2020