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Abby L. Pendleton
About Abby
Biography
Abby Pendleton is a founding partner of The Health Law Partners, P.C. She graduated Magna Cum Laude from Wayne State University Law School in 1996 and is a member of the Order of the Coif. Ms. Pendleton was a member of the Wayne State Law Review and served on its editorial board as a Senior Articles Editor. While at Wayne State, she was a recipient of the American Jurisprudence Book Awards in Contracts and Criminal Law as well as the Deloitte and Touche LLP Award for her achievement in tax law.
Ms. Pendleton has been practicing healthcare law since 1996. She regularly provides counsel to healthcare providers and organizations in a number of areas, including but not limited to: compliance, Recovery Audit Contractors (“RAC”), Medicare and other payor audits, fraud and abuse, reimbursement matters, and HIPAA Privacy and Security, and physician staff privilege and licensure matters. Ms. Pendleton also specializes in legal issues impacting billing and management companies, anesthesia and pain management providers, hospice providers and mental health agencies.
Ms. Pendleton is a member of the State Bar of Michigan (Member, Health Care Law Section); the American Health Lawyer's Association; the Health Care Compliance Association; the Medical Group Management Association and the Michigan Medical Group Management Association.
Practice Areas
1
Practice Area
Health Care
100%
30 years
Fees and Rates
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Chat withLicenses
Licensed in New York for 16 years
State: New York
Acquired: 2009
No misconduct found
Licensed in Michigan for 29 years
State: Michigan
Acquired: 1996
No misconduct found
Location
The Health Law Partners, P.C.
32000 Northwestern Highway, Suite 240, Farmington Hills, MI, 48334
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Abby L. Pendleton's Reviews
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Abby L. Pendleton's Lawyer Endorsements
"Abby is an experienced health care law attorney who practices in the areas of compliance, government and other payor audit defense, false claims defense, among many other areas. She continually goes above and beyond what is required in order to provide the best legal counsel to her clients. Abby and I often work jointly on many cases and I have always known her to be a knowledgeable, dedicated attorney whose expertise has proven to be crucial for her clients’ cases. She is regularly asked to speak around the country on a variety of health care legal topics."
"Abby Pendleton is a highly experienced attorney in the field of healthcare law. She leads her law firm’s Medicare and Recovery Audit Contractor (RAC) practice group, and also practices in all other areas of health care law, with special emphasis on the areas of Medicare and Medicaid audits, compliance and contracting. She is driven to succeed on behalf of her clients and advocates for them effectively and decisively. Her years of experience in healthcare law are invaluable and contribute to her acclamation as a reliable, successful attorney."
Robert Iwrey
Health care lawyer
Jessica Gustafson
Health care lawyer
Experience
Honors
2013
Attorney of The Month, Attorney at Law Magazine
2011
Top Lawer in Healthcare Law, d'Business Magazine
2011
Women in the Law, Michigan Lawyers Weekly
1996
Award for Tax Law, Deloitte & Touche LLP
1996
Award in Contracts and Criminal Law, American Jurisprudence Book Awards
Work Experience
2009 - Present
Founding Partner, The Health Law Partners, PC
1994 - 2009
Partner, Associate, Law Clerk, Wachler & Associates, P.C.
Associations
State Bar of Michigan, Health Care Law Section
Member
American Health Lawyers Association
Member
Health Care Compliance Association
Member
Medical Group Management Association
Member
Michigan Medical Group Management Association
Member
Education
1996
Wayne State University Law School
JD - Juris Doctor
1993
Central Michigan University
B.S.B.A.
Speaking Engagements
2019
The 7th National Physician Advisor and Utilization Review Boot Camp
Hot Legal Issues with MA Plans
2018
The 6th National Physician Advisor and Utilization Review Team Boot Camp 2018
Regulatory Update - 60 Day Recoupment, CMS/OMHA Appeal-Reduction, Front-End Compliance and Appeals
2018
Special Edition Finally Friday
Courts Recognize Irreparable Harm to Providers Caused by Medicare Appeals Backlog
2018
2018 National Physician Advisor Conference/SEPAS 2018
Denials Scene
2018
2018 National Physician Advisor Conference/SEPAS 2018
Mission Creep: The Physician Advisor and Payer Contracts
2018
15th Annual Physician Advisor and Medical Director summit
Mock ALJ Hearing
2017
5th National Physician Advisor and Utilization Review Boot Camp
Meet the Dream Team: 5) Legal Team - When All Else Fails
2017
5th Annual West Physician Advisor & Case Management Summit
Manage Medicare Denials Amdist Perceived Inconsistency and Lack of Transparency
2017
14th Annual Physician Advisor Summit
Develop Effective Strategies for Addressing Appeals and Denials
2015
3rd Annual Physician Advisor and UR Team Boot Camp
Beyond Filing Appeals - Proven Success Strategies Using PAs
2015
2015 Annual Meeting
Successfully Appealing Medicare Claims Denails (Case studies)
2015
12th Annual National Association of Physician Advisor ("NAPA") Physician Advisor Summit
Overcome Claim Denials with an Administrative Law Judge through Effective Positioning and Oral Arguments
2014
Pre-Summit Workshop
Overview and Recap of the 2014 CMS IPPS Final Rule
2014
Pre-Summit Workshop
Successfully Deal with Denials
2014
Michigan Regional Seminar
Healthcare Laws and Legal Issues
2014
American Academy of Orthopaedic Surgeons Annual Meeting
Compliance in 2014: What you Need to Know!
2014
2nd Annual West Physician Advisor & Case Management Summit
Strategies to Successfully Manage Denials and the Appeals Process
2014
20th Annual Health Law Institute
Advanced Practice Providers-The Role of Nurse Practitioners
2013
Transitioning to Accountable Care Organizations
Legal Issues Arising from Health Information Technology
2013
American Academy of Orthopaedic Surgeons Annual Meeting
Compliance 2013- What You Need to Know
2013
AIS Webinar
CMS's New Two-Midnight Rule for Inpatient Admissions: Strategies for Hospital Compliance
2012
HCCS Webinar
How to Comply with Proposed CMS Overpayment Rules
2012
Compliance Update: RAC, HIPAA/HITECH, Hospital and Physician Compliance
Presentation on RAC Audits and Appeals
2012
AHLA Webinar
The Medicaid RAC Final Rule: What Legal Counsel Representing Healthcare Providers Need to Know
2012
AHLA Webinar
The Latest on Medicare RACs
2011
World Research Group Panel Discussion
Navigating Claim Denials
2011
What Radiology Practices Need to Know about Federal Auditing Programs
ZPICs, RACs, MICs and More:
2011
Fraud and Abuse Environment for Anesthesiologists
The Fraud and Abuse Environment Anesthesiologists
2011
Compliances Challenges
The Current Audit Landscape, Is Your Organization Prepared?
2011
Anesthesia Business Consultants' Anesthesia and Pain Medicine Update for 2011 Webinar
What's New In Compliance: Mandatory compliance plans, False Claims Act Enforcement (refunds of overpayments, EHR, compliance risks)
2011
Advanced Techniques for Acute and Chronic Pain Management
The Compliance Landscape for Chronic Pain
2011
AAA Conference
Legal Issues Regarding Difficult Pain Patients: Noncompliance, Drug testing and terminating physician/patient relationships
2011
15th Annual Compliance Institute
Compliance in the Age of Electronic Records
2010
The Audit Landscape for Michigan Providers and Suppliers
The Audit Landscape for Michigan Providers and Suppliers
2010
The Association of Imaging Management
Recovery Audit Contractors and Medicare Audits
2010
Society for Pain Practice Management Billing and Coding Workshop
Society for Pain Practice Management Billing and Coding Workshop
2010
Recovery Audit Contractors and Medicare Audits
Recovery Audit Contractors and Medicare Audits
2010
Recovery Audit Contractors and Medicare Audits
Recovery Audit Contractors and Medicare Audits
2010
Recovery Audit Contractors and Medicare Audits
Recovery Audit Contractors and Medicare Audits: Strategies for Successful Appeals
2010
Recovery Audit Contractors
Recovery Audit Contractors: Is Your Organization Ready for the RAC Attack?
2010
RAC and Medicare Appeals
RAC and Medicare Appeals: What Physicians Need to Know
2010
OIG's Roadmap for New Physicians
OIG's Roadmap for New Physicians
2010
Medicare and Third Party Payor Audits
Audits, Refunds, Denials, Appeals And All The Other Things The Can Sink Your Practice
2010
Anesthesia Administration
RAC Attack
2009
World Research Group Healthcare Management Conference
Managing the RAC Appeals Process
2009
Michigan Association of Physicians of Indian Origin (MAPI)
Recovery Audit Contractors
2008
National Hospice & Palliative Care Organization (NHPCO)
Recovery Audit Contractors and Medicare Audits
2008
Michigan Home Health Association (MHHA)
The Medicare Appeals Process and Strategies for Successful Appeals
2007
Society for Pain Practice Management (SPPM)
Multiple Topics
2007
Society for Pain Practice Management (SPPM)
Billing, Avoiding Malpractice
2007
Society for Pain Practice Management (SPPM)
Billing Coding and Compliance
2007
Health Care Compliance Association
Compliance Program Challenges & Opportunities
2007
BOC Athletic Trainer Regulatory Conference
The Future of Healthcare
2007
American Society of Addiction Medicine (ASAM)
Third Party Payor Audits
2006
United Communications Group Physicians National Summit
Fraud and Abuse Compliance Issues
2006
United Communications Group
How to Keep your DME Relationships Problem-Free
2006
Healthcare Association of Michigan (HCAM)
Key Legal Compliance Issues Facing Skilled Nursing Facilities
2006
Annual Meeting of the Medical Group Management Association (MGMA)
The New Medicare Appeals Process
2005
Society for Pain Practice Management (SPPM)
Operationalizing HIPAA Privacy and Security
2005
Society for Pain Practice Management (SPPM)
Medicare Appeals, Exclusive Contracts, Compliance, Legal Risks of Facility Ownership
2005
NC NICA 3rd Academic Medical Center Conference
State Laws and Regulations (Current Trends & Implications to AMCs)
2005
ICLE 11th Annual Health Law Institute
Understanding the Basics of HIPAA
2005
Decision Health's Private Payer Contract Solutions Conference
Top Five Clauses to Watch Out for in Private Payer Contracts
2003
United Communications Group Anesthesia Conference
Anesthesia Billing Compliance
2003
United Communications Group
HIPAA
2003
Medical Group Management Association (MGMA) Anesthesia Administration Assembly 2003 Conference in Montreal, Canada
HIPAA Compliance
2003
Federated Ambulatory Surgery Association 2003 Annual Meeting
Practical Steps to HIPAA Compliance for Ambulatory Surgery Centers
2002
United Communications Group
HIPAA Compliance
2002
Medical Group Management Association (MGMA)
Anesthesia Compliance
2002
Anesthesia Administration Assembly 2002 Conference
Anesthesia
2001
United Communications Group
Compliance for Pain Management Physicians
2001
United Communications Group
HIPAA Privacy Rule
2001
United Communications Group
Documentation and Monitoring of a Compliance Program
2001
United Communications Group
How to Boost Compliance in your Pain Practice
2000
United Communications Group
How to Boost Compliance in your Pain Practice
2000
Lorman Education Services
Medicare & Medicaid: Enforcement, Compliance and the Transition to Managed Care in Michigan
1999
United Communications Group
Development and Implementation of Compliance Programs for Anesthesia Practices
1999
United Communications Group
How to Boost Compliance in your Pain Practice
1999
Lorman Education Services
Medicare & Medicaid: Enforcement, Compliance and the Transition to Managed Care in Michigan
Publications
2019
2019
2019
ABA The Health Lawyer
District Court Rules OMHA Appeals Backlog to be Eliminated by 2022
2019
ABA Health eSource
Inpatient Rehabilitation Facility (IRF) Appeals Settlement Initiative
2019
2018
BC Advantage
CMS Removes Total Knee Arthorplasty from the Inpatient-Only List
2017
ABA The Health Lawyer
Medicare Appeals Adjudication Delay Update: Lawsuit Dedcided in Favor of Appellants (For Now)
2017
ABA The Health Lawyer
HHS Seeks to Improve Mediacre Appeals Process
2016
ABA Health eSource
Be on NOTICE: CMS's Proposed Rule on the NOTICE Act Has Been Published
2015
ABA Health eSource
Healthcare Providers and Suppliers Eagerly Anticipate Planned Improvements to Recovery Audit Program
2015
ABA Health eSource
Wading Through Muddy Waters: Hospitals Plan for Revisions to CMS' 2-Midnight Rule
2015
2014
2014
ABA The Health Lawyer
2-Midnight Rule Update: Hospitals Must Continue Implementation of the 2-Midnight Rule
2014
2014
New York State Bar Association
Medicare Audits of Physician Claims and the Medicare Appeals Process
2014
BC Advantage
The Latest Development in Federal Health Care Audit Programs: Supplemental Medical Review Contractor
2014
BC Advantage
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
2014
2014
American Case Management Association, Collaborative Case Management
Hospitals Must Continue Implementation of Controversial 2-Midnight Rule
2014
2013
AHLA Health Lawyers Weekly
CMS Publishes 2014 IPPS Final Rule: Revises Reimbursement Criteria Related To Patient Status
2013
ABA Health eSource
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?
2013
ABA Health eSource
The Latest Development in Medicare Audits: Supplemental Medical Review Contractor ("SMRC") Audits
2013
2012
ABA Health eSource
OIG Advisory Opinion 12-06: Insightful Guidance from the OIG For Structuring Company Model Arrangements
2012
2012
2011
G-2 Compliance Report
The Recovery Audit Contractor ("RAC") Program: What Can Laboratories and Pathologists Expect?
2011
Michigan Medical Law Report
Compliance Can Be Tricky in the Age of Electronic Medical Records
2011
Michigan Medical Law Report
RAC Program Proposed Rule Published
2011
Michigan Medical Law Report
The OIG's New Roadmap on Avoiding Fraud and Abuse
2011
2011
Association of Healthcare Internal Auditors New Perspectives
Sleeping Giants: Compliance in the Age of Electronic Medical Records
2011
ABA Health eSource
The Future of the Recovery Audit Contractor Program
2010
Michigan Medical Law Report
Proposed HIPAA Regulations: What Physician Practices Need to Know
2010
AHLA/AAPC Coding Manual
Legal/Regulatory/Fraud & Abuse/Compliance/Reimbursement Issues associated with Anesthesiology Coding
2010
Michigan Medical Law Report
Health care reform measures, increased audit scrutiny, and more reasons why compliance programs matter
2010
Michigan Medical Law Report
HIPAA enforcement strengthened, penalties increased
2010
Communique
The Anesthesia Community Must Be Prepared for Increased Audit Activity by RACS and Others
2010
The Communique
Breach Notification Final Rule
2010
Communique Fall
Compliance Corner: Focus on Compliance
2009
Communique
HITECH in a High Tech Era
2009
Health Lawyers Association, Hospitals and Health Systems Practice Group Member Briefing
Recovery Audit Contractors And Medicare Audits: What Can Hospitals and Health Systems Expect as the RAC Program Expands Nationwide?
2009
Communique
What Anesthesiologists And Pain Management Physicians Need to Know About The RAC Program
2009
Michigan Medical Law Report
Physicians Can Choose to Opt Out of Medicare Participation
2009
Michigan Medical Law Report
OIG Work Plan 2008: What can providers expect in 2008?
2009
Michigan Medical Law Report
Get Ready -- Recovery Audit Contractors Are Coming to Michigan
2009
Michigan Medical Law Report
Medicare eases rule on termination of provider medical records review
2009
Radiology Management
The RAC Program: What Can Radiology Providers Expect as RACs Begin Auditing
2008
The RAP Sheet, American Health Lawyers Association
The RACs Are Coming - Are You Ready?
2008
The Health Lawyer, The ABA Health Law Section
RAC to the Future: What Can Medicare Providers and Suppliers Expect from the Recovery Audit Contractor Program?
2008
Michigan Medical Law Report
Is Medicare being billed the right way? Here's how to avoid the risks
2008
Michigan Medical Law Report
Can Medicare take my money? What the One-Time Notification means
2008
Caring, National Association of Home Care and Hospice
Recovery Audit Contractors and Medicare Audits: Successful Strategies for Defending Audits
2008
Anesthesia Business Consultants Communique
Compliance Corner: OIG Workplan 2008
2008
Anesthesia Business Consultants Communique
Planning for Compliance
2007
HCCA Compliance Today
Get Ready: RACs may be nationwide sooner than expected!
2007
Michigan Medical Law Report
Legal issues impacting physician recruitment relationships
2007
Michigan Medical Law Report
Get ready for increased nationwide Medicare audit activity
2006
Health Law Handbook 2006
The New Medicare Part A and Part B Appeals Process
2006
Michigan Medical Law Report
What all physicians need to know about the proposed changes to the Medicare physician fee schedule
2006
Michigan Medical Law Report
Prescribing controlled substances: What every physician should know
2006
Michigan Medical Law Report
The Michigan Social Security Number Privacy Act, new whistleblower provisions of the Michigan Medicaid False Claims Act and more
2005
Michigan Medical Law Report
Billing: Three key compliance tips that every physician should implement
2005
The Health Lawyer, The ABA Health Law Section
The New Medicare Appeals Process
2005
Michigan Medical Law Report
Compliance Auditing: Three Key Issues That Every Physician Should Consider
2004
Anesthesia Business Consultants Communique
Third-Party Payor Audits: The Impact on Anesthesia Groups
2004
Laches
Third-Party Payor Audits: Impact on Physician and Healthcare Provider Clients
2003
MSA Ventilator
Have you Engaged in Compliance Activities Lately?
2003
Update: Journal of the Federated Ambulatory Surgery Association
New HIPAA Privacy Guidance Reduces ASC Fears
2003
The Health Lawyer, The ABA Health Law Section
Final HIPAA Security Rule Allows Greater Flexibility
2003
The Health Lawyer, The ABA Health Law Section
Medicare Appeal and Recovery Reforms under the Medicare Prescription Drug, Improvement and Modernization Act of 2003
2000
The Health Lawyer, The ABA Health Law Section
OIG Softens its Overall Approach in Releasing the Final Compliance Guidance for Individual and Small Group Physician Practices
2000
Anesthesia Business Consultants Communique
Cpt 2000: Pain Management Coding Compliance
2000
Health Care Weekly Review
Hospice Providers are Well Advised to Address OIG Identified Hospice Risk Areas
2000
The Health Lawyer, The ABA Health Law Section
OIG Issues Draft Compliance Guidance for Individual and Small Group Physician Practices
1999
Anesthesia Business Consultants Communique
OIG Issues Special Advisory Bulletin on Gainsharing Arrangements
1999
Anesthesia News
Continuing Education is Key to Compliance
1999
The Health Lawyer, The ABA Health Law Section
OIG Issues Compliance Guidance for the Hospice Industry and Medicare + Choice Organizations
1998
Anesthesiology News
HCFA Issues Final Rule on Medical Direction
N/A
United Communications Group
HIPAA Privacy Workbook and Toolkit
N/A
United Communications Group
HIPAA Security Workbook and Toolkit
N/A
FASA
HIPAA Security Workbook and Toolkit
N/A
FASA
HIPAA Privacy Workbook and Toolkit
N/A
Anesthesia Business Consultants Communique
Anesthesia Time: Compliance Tips
Languages
English