The First Healthcare Compliance team is committed to excellence and strives to serve as a trusted resource for compliance professionals, healthcare administrators, providers, and business associates. We’re honored to serve with an Editorial Council comprised of experts who are at the top of their fields covering all aspects of GRC and health law.
Stephen Bittinger is Partner with K&L Gates in the firm’s Charleston office and a member of the health care/FDA practice group. Mr. Bittinger focuses his practice on health care reimbursement compliance, defense and litigation, with a focus on government and private payer disputes on behalf of providers, vendors, and manufacturers involved in the United States health care system. He has extensive experience representing large provider groups, home health agencies, medical facilities, ancillary service providers, medical labs, revenue cycle management companies, and drug and device manufacturers in matters including Medicare and Medicaid audits, private payer audits, federal regulatory termination and exclusion proceedings, False Claims Act prosecutions, and health care revenue issues.
In addition, he has experience advising clients on defending and appealing audits by Recovery Audit Contractors, Zone Program Integrity Contractors, and Unified Program Integrity Contractors and has worked collaboratively with government regulators and health care provider associations across the United States. Bittinger has represented many providers and vendors with federal agency matters in Washington, D.C., including the Centers for Medicare and Medicaid Services (CMS) Center for Program Integrity (CPI), the Department of Health and Human Services Office of Inspector General (HHS-OIG), the Department of Veteran Affairs (VA), and Health Care Fraud division of the Department of Justice (DOJ).
Prior to joining the firm Mr. Bittinger served at a regional commercial law firm where he focused his practice on health care reimbursement defense and litigation. Previously, Mr. Bittinger and team represented numerous types of physician practices, home health agencies, medical facilities, ancillary service providers, medical laboratories, revenue cycle management companies, and drug/device manufacturers in Medicare audits (RAC, ZPIC, UPIC, TPE), Medicaid audits (SIU), private payors audits, federal regulatory termination, and exclusion litigation related to the health care revenue cycle.
Jennifer Gimler Brady
Jennifer Gimler Brady, Partner and General Counsel at Potter Anderson Corroon LLP, concentrates her practice in the areas of health law, labor and employment law, and commercial litigation. She regularly advises long-term care providers, physician practices and other health care providers on a variety of issues, including licensing and certification, fraud and abuse laws, medical privacy and confidentiality, and litigation matters. Jennifer also counsels employers on labor and employment issues, including unionization and collective bargaining, employee supervision, discipline and discharge, sexual harassment, and employment discrimination.
Jennifer is a frequent lecturer on such topics as employment practices, fraud and abuse laws, long-term care litigation and regulation, medical records confidentiality, compliance under the Health Insurance Portability and Accountability Act (“HIPAA”), and medical practice management. Recent speaking engagements include: seminars on exclusions under federal health care programs, reasonable accommodations under the Americans with Disabilities Act, business associate agreements under HIPAA, and “hot topics” for employers.
A longtime participant in firm committees and management, Jennifer currently serves as General Counsel to the firm. She is a former practice leader of the firm’s General Litigation Group and a former member of the firm’s Executive Committee.
For well over a decade Shauna Itri, Partner at Seeger Weiss LLP, has been leading litigation teams in complex fraud cases in both state and federal courts. Shauna’s nationwide practice has focused on representing plaintiffs in various settings, including class action securities and consumer matters; antitrust; and cases involving patient harm. Shauna also has extensive experience representing whistleblowers in False Claims Act lawsuits, and tax and securities whistleblowers with claims under the IRS and SEC whistleblower programs. After obtaining her law degree, Shauna sought to represent plaintiffs because of her deep-seated notions of fairness and her desire to represent individuals who wanted to bring corporate fraud to light. She believes the key to success in complex litigation is using experience to lay bare various defense tactics that are designed to obscure the truth. Shauna’s temperament brings a sense of calmness to her litigation teams, even under the most demanding conditions. Using her legal skills, vision, work-ethic, and attention to detail, she has regularly generated multi-million-dollar settlements for her clients.
Prior to becoming an attorney, Shauna received a B.A. and an M.A. from Stanford University, where she was two-time captain of the University’s women’s nationally ranked soccer team. She received her J.D. from Villanova University.
Shauna is an avid volunteer and educator. She has served as an adjunct professor at Villanova University (2011-2013) and Widener Law School (2013-2018), teaching corporate deviance courses. Shauna currently serves as co-chair of Stanford University Alumni Undergraduate Admissions Volunteer Interview Program, and is the President of the Junior League of Philadelphia, Inc., an organization of approximately 800 women committed to promoting voluntarism, developing the potential of women, and improving the community through the effective action and leadership of trained volunteers.
Jennifer Kirschenbaum, Esq.
Jennifer Kirschenbaum, Esq., is the managing partner of Kirschenbaum & Kirschenbaum, P.C.’s healthcare department. Jennifer devotes her practice towards assisting practitioners in all aspects of private practice, Office-Based Surgery practice, Article 28 facility formation and operation, Independent Practice Association formation and operation, as well as hospital based practice and hospital relationships/arrangements. After bringing healthcare to Kirschenbaum and Kirschenbaum, P.C. in 2008, Jennifer has grown the firm’s healthcare department to representing over 1200 practices, Article 28 facilities, IPAs and small to mega-group private practices. K&K’s healthcare department represents MDs, DOs, DPMs, DDS, DMDs, DCs, PTs as well as other practitioners. Jennifer operates the healthcare department in conjunction with the other practice areas of law at the firm. When necessary our litigation, real estate, trust and estates or bankruptcy attorneys are available to assist in matters related to healthcare, and frequently do where issues involving practice break-ups, trademark infringement, breach of contract, etc., arise. Practitioners contact Jennifer at all stages of practice, from their first employment agreement review and negotiation, their first lease, first partnership agreement, first patient issue, first lawsuit, first HIPAA complaint, first hospital contract, collection issues, audit through partnership structuring, mergers and acquisitions, practice sale, hospital employment or closure and everything in between. We are here to assist in any and all issues that arise that cannot be easily addressed internally or require third party consultation.
Jennifer offers a free newsletter for the healthcare community. You can sign up with her by emailing Jennifer@Kirschenbaumesq.com Jennifer may be reached at (516) 747-6700 x. 302.
William J McBorrough
William J McBorrough is an Information Assurance and Cyber Security Leader, Researcher, Educator and Entrepreneur with an extensive background managing, designing, and implementing medium and large enterprise physical and information technology security solutions and programs.
Mr. McBorrough is co-Founder and Chief Security Advisor at MCGlobalTech, a Washington, D.C.-based Information Security Consulting Firm helping clients protect their brand, data and clients from cybersecurity threats and data breaches. For more than 20 years, Mr. McBorrough has demonstrated success as a security administrator, engineer, architect, consultant, manager and practice leader developing cost effective solutions to enable and support strategic and operational goals of client organizations in the areas of Enterprise Information Security Risk Management, IT Governance, Security Organization Development and Management, and Government Information Assurance and Compliance. His experience spans the spectrum from small e-commerce start-ups to multi-campus state and federal government agencies to global financial sector organizations.
Mr. McBorrough has served on the faculty of various universities for the last 11 years including University of Maryland University College, EC-Council University, George Mason University and Northern Virginia Community College where he has conducted research and taught graduate and undergraduate courses relating to cybersecurity, cybercrime, cyberterrorism, and information security and assurance.
Mr. McBorrough is a Certified Information Systems Security Professional (CISSP), Certified Information Systems Auditor (CISA), Certified in Risk Information System Control (CRISC), Certified Ethical Hacker and HITRUST Certified Common Security Framework Practitioner (CCSFP).
Kathleen W. McNicholas, MD, JD, CHC, CCEP
Kathleen W. McNicholas, MD, JD, CHC, CCEP earned an MD from Jefferson Medical College magma cum laude and completed general surgery training at Columbia Presbyterian Medical Center and served as a surgical house officer in London at the Hospital for Sick Children, Great Ormond Street. She remained at CPMC for cardiothoracic training and chief residency then returned to GOS as a senior registrar in the cardiac unit. Dr. McNicholas was chief of pediatric cardiac surgery at Deborah Heart and Lung Center prior to starting the cardiac surgery program in Delaware. Seeking a hobby, she studied law at the Delaware Law School and earned a JD cum laude and an LLM in health law with honors. After retiring from clinical practice, she completed a fellowship in patient safety leadership and became the medical director of performance improvement and patient safety and lead the Just Culture program and CANDOR. Currently, Dr. McNicholas is a consultant and patient advocate.
Melody W. Mulaik
Melody W. Mulaik is the President of Revenue Cycle Coding Strategies. She is a frequent speaker and author for nationally recognized professional organizations and publications. Melody’s areas of expertise include coding and compliance, management engineering, operations improvement and she is nationally recognized for her extensive radiology expertise.
Melody often speaks at national conferences on many topics including Interventional and Diagnostic Radiology coding, Internal Audit Program Development, Coding Compliance and other healthcare compliance issues. Recent speaking engagements include the Association of Community Cancer Centers (ACCC), AHRA: The Association for Imaging Management, Radiology Business Management Association (RBMA), Healthcare Billing Management Association (HBMA) and the Radiological Society of North America (RSNA). Melody is the AHRA liaison to the American College of Radiology (ACR) Economics Commission and her firm, RCCS, serves as consulting support for the Society of Interventional Radiology (SIR).
Melody is a frequent author for national publications and writes the bi-monthly coding column for AHRA’s Radiology Management and the Healthcare Billing Management Association’s (HBMA) Billing. Her work has also appeared in RT Image, Imaging Economics, Radiology Today, and Radiology Business Journal. Melody co-authored Revenue Cycle Coding Strategies’ Coding Guides for Diagnostic Radiology and Interventional Radiology.
Prior to her current position, Melody held the position of Vice President of Billing Compliance for the largest national billing company, where she was responsible for the implementation, oversight, and maintenance of the billing compliance program.
Melody holds a Master of Science in Health Systems (MSHS) degree and a Bachelor of Industrial Engineering (BIE) degree, both from the Georgia Institute of Technology (Georgia Tech), in Atlanta, Georgia. She also holds the professional certification of Certified Radiology Administrator (CRA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC) and Radiology Certified Coder (RCC), and Radiology Certified Coder – Interventional (RCC-IR). Melody has achieved Fellow status with the AHRA (FAHRA) and is a recent recipient of the prestigious AHRA Gold Award for her organizational and industry contributions.
Iliana L. Peters
Iliana L. Peters believes good data privacy and security is fundamental to ensuring patients’ trust in the health care system, and to helping health care clients succeed in an ever-changing landscape of threats to data security. She is recognized by the health care industry as a preeminent thinker and speaker on data privacy and security, particularly with regard to HIPAA, the HITECH Act, the 21st Century Cures Act, the Genetic Information Nondiscrimination Act (GINA), the Privacy Act, and emerging cyber threats to health data.
For over a decade, she both developed health information privacy and security policy, including on emerging technologies and cyber threats, for the Department of Health and Human Services, and enforced HIPAA regulations through spearheading multi-million dollar settlement agreements and civil money penalties pursuant to HIPAA. Iliana also focused on training individuals in both the private and public sector, including compliance investigators, auditors, and State Attorneys General, on HIPAA regulations and policy, and on good data privacy and security practices.
As a CISSP, Iliana works hard to bridge the gap between legal requirements for the security of health data and security industry best practices, so that clients can better understand data security issues and jargon. She is excited to bring her extensive experience drafting, implementing, and enforcing health privacy and security regulations and guidance to a practice that focuses on helping clients develop and implement good data privacy and security practices to avoid risk, and helping clients prepare for and recover from emerging cyber threats.
Raymond Ribble is the founder of SPHER Inc. and co-founder of Fusion Systems Co., Ltd. Ray leads the SPHER organization as they deliver privacy & security cybersecurity solutions in healthcare.
SPHER represents the leading SaaS-based privacy monitoring security solution for HIPAA Compliance, Meaningful Use, and MIPS offering overall protection of patient health information.
Ray participates in a number of healthcare groups, speaks at universities, industry conferences and webinars, while actively contributing to the growing awareness of the need to identify unauthorized access to PHI and breach detection.
With over 25 years in the technology industry, Ray has been involved in delivering solutions for multiple industries from Aerospace with Northrop, to investment banking financial systems in Asia for many of the world’s top banks, to the recent creation of machine learning-based solutions for the US Healthcare markets.
Ray remains active in international businesses and technology communities including: PHI Protection Network, Medical Identity Fraud Alliance, the American Chamber of Commerce in Japan (ACCJ) as past Co-Chairman of the ICT Committee, the Japan America Society, the YMCA, as well as many charities.
Ray holds a BSc. in Aerospace Technology & Management from Western Michigan University, and completed his advanced Japanese Studies at UCLA.
Rachel V. Rose, JD, MBA
Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX has a unique background, having worked in many different facets of healthcare, securities and international law and business throughout her career. Her practice focuses on a variety of cybersecurity, health care and securities law issues related to industry compliance and transactional work, as well as representing plaintiffs in Dodd-Frank/False Claims Act whistleblower claims, which remain under seal.
Ms. Rose holds an MBA with minors in healthcare and entrepreneurship from Vanderbilt University, and a law degree from Stetson University College of Law, where she graduated with various honors, including the National Scribes Award and The William F. Blews Pro Bono Service Award. Ms. Rose is licensed in Texas. Currently, she is the Chair of the Federal Bar Association’s Government Relations Committee, the co-editor of the American Health Lawyers Association’s Enterprise Risk Management Handbook for Healthcare Entities (2nd Edition), as well as a co- author of the books The ABCs of ACOs and What Are International Business Considerations? She has been named consecutively to the Texas Bar College, the National Women Trial Lawyers Association’s Top 25 and Houstonia Magazine’s Top Lawyers for healthcare. Ms. Rose is an Affiliated Member with the Baylor College of Medicine’s Center for Medical Ethics and Health Policy, where she teaches bioethics.
Lauren specializes in the representation of employers on a range of issues relating to compliance with local, state, and federal labor and employment laws and constitutional provisions. She provides compassionate and responsive counsel, targeted at achieving client goals while minimizing cost and risk.
Lauren emphasizes client counseling—on issues ranging from wage and hour compliance, to workplace training and investigations, to effective employee terminations—with the goal of avoiding litigation before it begins. Her counseling practice includes handbook revisions, effective policy implementation, and on-site training on legal compliance.
Lauren has developed and conducts specialized in-house training for emerging legal issues including the pregnancy, reproductive rights, and family care provisions of the Delaware Discrimination in Employment Act. One of her current programs outlines the complexities of the #MeToo movement and offers executives essential information on harassment avoidance and modifying corporate culture. Lauren also conducts high-level investigations of discrimination and harassment on behalf of employers.
When litigation becomes necessary, Lauren is a dedicated advocate, aggressively pursuing her clients’ best interests and providing clear guidance at each stage of the proceeding. Lauren has litigated a wide variety of employment-related matters to successful resolutions, including employment discrimination, non-competition, and constitutional law cases. Lauren has experience in each of Delaware’s state and federal courts, as well as the U.S. Court of Appeals for the Third Circuit. Lauren also regularly assists clients in administrative proceedings before state and federal administrative agencies, including the EEOC, the Delaware Office of Anti-Discrimination, and the Delaware Unemployment Insurance Appeals Board.
Liz is Chair of McDonald Hopkins’ national Healthcare Practice Group and a member of the firm’s Board of Directors. She began her legal career in the Healthcare Practice group at McDonald Hopkins and later served as an attorney in the legal department at The Cleveland Clinic Foundation before returning to McDonald Hopkins as a member.
While at the Cleveland Clinic, Liz provided regulatory advice and transactional guidance to various service lines, including the clinical laboratory, professional pathology, imaging, transplant, and remote and distance health teams. Over the course of her career, Liz has assisted various types of healthcare providers, including clinical laboratories, hospitals, physician specialty groups, telehealth providers, transplant centers, and surgery centers.
Liz has experience providing regulatory, licensing, compliance, reimbursement, contractual, and corporate guidance to clients. She has advised clients on state professional licensure laws, CLIA standards, state laboratory laws, government and private payor reimbursement policies and billing rules, federal and state fraud and abuse rules and regulations, state telehealth laws, and HIPAA rules and regulations. She has provided assistance to entities during licensure and accreditation surveys, government investigations, and through payor audits and disputes.
In addition to providing regulatory guidance to clients, Liz is also knowledgeable in evaluating how a business opportunity or arrangement implicates a provider’s unique regulatory framework. Liz has counseled clients not only on the regulatory aspects of an arrangement as described above, but she is also experienced in reviewing and negotiating relevant contractual and legal documentation in connection with contemplated business arrangements.
Liz earned a J.D. and Certificate of Advanced Studies in Health Law from the University of Pittsburgh School of Law, an M.A. in Bioethics and a B.A., cum laude, in Political Science from Case Western Reserve University.
Sheba E. Vine, Esq., CIPP/US
Sheba Vine is a Senior Manager in the Global Privacy Office at Exact Sciences Corporation. She received her Juris Doctorate from Widener University School of Law and her Bachelor of Science in Biomedical Engineering from Drexel University. She is licensed to practice law in Delaware, New Jersey, Pennsylvania, and before the U.S. Patent and Trademark Office and is accredited by the International Association of Privacy Professionals as a Certified Information Privacy Professional.
Catherine Walters, Partner at Bybel Rutledge LLP, provides exclusive management-side labor and employment services for employers of all sizes, including privately and publicly held companies, government contractors, institutions of higher education, health care providers, trade associations and other non-profit organizations. Her practice spans an array of industries, including financial and banking, manufacturing, defense contracting, education, health care, professional services, insurance, construction, technology, retail, real estate, transportation, restaurant and hospitality. Catherine’s extensive experience and collaborative skills enable her to partner with her clients to develop creative, practical, business-oriented solutions to their legal challenges. She focuses on identifying current and emerging trends in order to provide clients with proactive legal advice aimed at managing and preventing emerging risks. Her emphasis on strategic thinking and focused solutions enables her to provide employers with the sophisticated counsel that has become necessary in today’s complex business environment. Catherine regularly appears before federal and state courts and administrative agencies where she handles both employment and traditional labor matters.