Katherine Bowles

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.

Anesthesia Group Hospital Acquisition Negotiated foundation acquisition of anesthesia group in Northern California at multi-hospital system.

Anesthesia Partnerships and Contracting Routinely represent anesthesia providers in creating new entities and establishing contractual relationships with providers and payors.

Hospital Acquisition Litigation Managed discovery and litigated through resolution a large-scale failed hospital acquisition involving five hospitals in California.

Behavioral Health Reimbursement Dispute Litigated large-scale mental health parity reimbursement dispute on behalf of substance use disorder treatment program.

Payor-Provider Coverage Disputes Routinely represents hospitals and health care providers in disputes with commercial payors, including everything from demand letters to arbitration and trial.

Hospital Billing and Pricing Advice Assisted five-hospital system in California with overhauling billing and pricing policies for patient charges, payment and collection for both commercial and government payors.

Surgery Center Business Litigation Successfully resolved several ambulatory surgery center (ASC) litigation disputes involving ownership, operations, provider exclusivity, confidentiality and Stark/Anti-Kickback Law.

Telehealth Regulatory and Transactional Advice Provide strategic guidance to rapidly expanding telehealth entity, including acquisition of a pharmacy and laboratory.

Federal False Claims Act Litigation Managed discovery and e-discovery and led internal strategy meetings for 14-hospital system defense to allegations of upcoding and emergency versus observational status of patients.

California Insurance Frauds Prevention Act Litigation Successfully represented hospital system against whistleblower allegations of patient inducement of treatment by inpatient detoxification unit in hospital.

Workers’ Compensation Regulatory and Compliance Advice Draft strategic legal briefing concerning key legal issues for collection of large book of workers’ compensation receivables and assist workers’ compensation providers in achieving internal regulatory compliance.

Behavioral Health Internal Investigations and Plans of Correction Respond to significant patient incidents necessitating internal compliance review and development of Mitigation Plans, including updated policies, training, staffing, leadership and auditing.