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Jessica Lee Gustafson
About Jessica
Biography
JESSICA L. GUSTAFSON is a founding shareholder with The Health Law Partners, P.C. Ms. Gustafson represents hospitals, health systems, hospices, home health agencies, physicians and other health care providers and suppliers in an array of health care legal matters. Ms. Gustafson devotes a substantial portion of her practice to representing providers in the Recovery Audit (“RAC”) and Medicare audit appeals process. She also regularly assists clients with compliance and reimbursement matters, overpayment refunds, Medicare enrollment matters, as well as other health care regulatory matters.
Ms. Gustafson is a member of the American Health Lawyers Association, American Bar Association (Health Law Section) and Michigan Bar Association (Health Care Law Section). She is actively involved in the ABA Health Law Section, serving as Chair of the Physician Issues Interest Group, a Co-Chair of the Membership Committee, and as a Vice-Chair of the Editorial Board of the publication ABA Health eSource. She also serves as a member of the Advisory Board to the American College of Physician Advisors.
While in law school, Ms. Gustafson served as a member of the Wayne Law Review Editorial Board as a Senior Articles Editor. She also served as a judicial intern to the Honorable Robert H. Cleland, United States District Court, Eastern District of Michigan.
Practice Areas
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Practice Area
Fees and Rates
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Chat withLicenses
Licensed in New York for 6 years
State: New York
Acquired: 2019
No misconduct found
Licensed in Michigan for 20 years
State: Michigan
Acquired: 2005
No misconduct found
Location
The Health Law Partners, P.C.
32000 Northwestern Highway, Suite 240, Farmington Hills, MI, 48334
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Practice Areas
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Posted by Carey | November 27, 2018 | Health Care
Dedicated health care law attorney
I have worked and consulted with Jessica for many years. She is a hard-working, award-winning health care law attorney with substantial experience in the areas of Medicare, Medicaid, and other payor audits, compliance and reimbursement matters, among many others. Her expertise in her areas of practic...
Jessica Lee Gustafson's Lawyer Endorsements
"Jessica Gustafson has a great deal of experience in the field of healthcare law, especially regarding Recovery Audit Contractors and Medicare and Medicaid audits. Her expertise in her area of practice, combined with her intelligence and commitment to her clients, makes her a valuable asset to the legal community and to anyone seeking a lawyer for healthcare-related purposes."
Adrienne Dresevic
Health care lawyer
Experience
Honors
2019
Rising Star, Super Lawyers
2018
Rising Star, Super Lawyers
2017
Rising Star, Super Lawyers
2016
Rising Star, Super Lawyers
2015
Rising Star, Super Lawyers
2014
Rising Star, Super Lawyers
2013
Rising Star, Super Lawyers
2013
Attorney of the Month, Attorney at Law Magazine
2012
Rising Star, Super Lawyers
2010
Up and Coming Lawyer 2010, Michigan Lawyers Weekly
Work Experience
2009 - Present
Partner, The Health Law Partners, P.C.
2004 - 2009
Associate, Law Clerk, Wachler & Associates, P.C.
Associations
2008 - Present
Oakland County Bar AssociationChair, Medical/Legal Committee (2009-2010)
2005 - Present
Michigan Bar Association, Health Law SectionMember
2005 - Present
American Bar Association, Health Law SectionMember
2005 - Present
American Health Lawyers AssociationMember
Education
2005
Wayne State University Law School
JD - Juris Doctor
2002
Miami University
BA - Bachelor of Arts
Speaking Engagements
2020
CMSA 2020 Annual Conference Virtual Edition
Legal Issues Affecting Hospital Case Managers
2019
The 7th National Physician Advisor and Utilization Review Boot Camp
Hot Legal Issues with MA Plans
2019
2018
The American Bar Association Health Law Section & Chicago Medical Society Physicians Legal Issues Conference
Will Medicare Revoke Your Billing Privileges? Don't Answer "No" Too Quickly
2018
The 6th National Physician Advisor and Utilization Review Team Boot Camp
Regulatory Update - 60 Day Recoupment, CMS/OMHA Appeal-Reduction, Front-End Compliance and Appeals
2018
The 2018 National Physician Advisor Conference/SEPAS 2018
Denials Scene
2018
The 15th Annual Physician Advisor and Medical Director Summit
Cost Breakdown of Denials Management
2018
Special Edition Finally Friday
Courts Recognize Irreperable Harm to Providers Caused by Medicare Appeals Backlog
2018
15th Annual Physician Advisor and Medical Director Summit
Mock ALJ Hearing
2017
Webinar
Avoiding Compliance Pitfalls with the Use of Electronic Medical Records
2017
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 Amidst Perceived Inconsistency and Lack of Transparency
2017
14th Annual Physician Advisor Summit
Develop Effective Strategies for Addressing Appeals and Denials
2017
14th Annual Physician Advisor Summit
Drive Effective Collaboration between Payers and Providers
2016
Strafford Nationwide Webinar
Medicare Provider Enrollment: Strategies for Denials, Revocations and Appeals
2016
National Association of Physician Advisors 13th Annual Physician Advisor Summit
Effective Strategies for Dealing with Denials and Appeals
2016
5th Annual Southeast Physican Advisor Symposium
Appealing to the ALJ: Strategies for Success
2016
4th Annual West Physician Advisor & Case Management Summit
The Current Audit Structure and Proposed Changes to the Medicare Appeals Process
2016
13th annual Observation Management Summit
Examine the Modified Two-Midnight Rule and Its Impact on the Documentation Process
2015
Gulf Coast 2015 Fall Institute
Medicare Audits and Appeals Environment: What Hospitals Need to Know
2015
3rd Physician Advisor and UR Team Boot Camp
How to Handle Difficult Situations - Point-Counterpoint (panel discussion)
2015
3rd Physican Advisor and UR Team Boot Camp
Beyond Filing Appeals - Proven Success Strategies Using PAs
2015
3rd Annual National Association of Physician Advisors ("NAPA") Phsyican Advisor & Case Management Summit
Understanding Changing CMS Rules and Regulations to Maintain Learning and Improve Quality
2015
2015 Annual Meeting
Successfully Appealing Medicare Claims Denials (Case studies)
2015
12th Annual National Association of Physician Advisors ("NAPA") Physican Advisor Summit
Overcome Claim Denials with an Administrative Law Judge through Effective Positioning and Oral Arguments
2014
National Association of Physician Advisors Summit
Overview and Recap of the 2014 CMS IPPS Final Rule
2014
National Association of Physician Advisor Pre-Summit Workshop
Successfully Deal with Denials
2014
2nd Annual West Physician Advisor & Case Management Summit
Strategies to Successfully Manage Denials and the Appeals Process
2014
2014 MAC Fall Express Conference
The Business of Chiropractic: An Ounce of Prevention is Worth a Pound of Cure
2014
2014 AHRA Annual Meeting
What Radiology Practices Need to Know
2013
National Physician Advisor and Utilization Review Boot Camp
Two-Midnight Rule: Implications for Auditor Behavior and Appeal Strategies
2013
Huron Valley Physician Association
Increased Scrutiny on Health Care Providers and How to Avoid Becoming A Target
2013
Finally Friday
2014 IPPS Final Rule
2013
AIS Webinar
CMS's New Two-Midnight Rule for Inpatient Admissions: Strategies for Hospital Compliance
2013
41st Annual Meeting and Exposition
The Medicare Audit Landscape: What Radiology Practices Need to Know
2013
41st Annual Meeting and Exposition
Recent Developments and Key Legal Issues Impacting Radiology Practices
2013
41st Annual Meeting and Exposition
Regulations Impacting Healthcare Marketing
2012
National Business Institute Teleconference
Medicare Audit Appeals: Representing Healthcare Providers
2012
AHLA Webinar
The Medicaid RAC Final Rule: What Legal Counsel Representing Healthcare Providers Need to Know
2012
40th Annual Meeting and Exposition
Regulations Impacting Healthcare Marketing
2012
40th Annual Meeting and Exposition
Recent Developments and Key Legal Issues Impacting Radiology Practices
2012
2012 Spring Conference
The Medicare Audit Landscape, What Radiologists Need to Know
2012
2012 AAMA Annual Conference
ICD-10: Compliance Risks and Mitigation Strategies
2011
World Research Group
Navigating Claim Denials - Panel Discussion
2011
State Bar of Michigan Health Care Law Section Teleconference
The Michigan Audit Landscape: Medicare, Medicaid, and Private Payor Audits
2011
Nebraska Hospice and Palliative Care Association 2011 Annual Conference
An Unprecedented Era of Claims Scrutiny: Successfully Managing Targeted Medical Review, Recovery Audit Contractor and Medicaid Integrity Audits
2011
Health Care Compliance Association's 15th annual Compliance Institute
Compliance in the Age of Electronic Health Records
2011
AHRA 39th Annual Meeting & Exposition
ZPICs, RACs, MICs and More: What Radiology Practices Need to Know about Federal Auditing Programs
2011
AHRA 39th Annual Meeting & Exposition
Recent Developments and Key Legal Issues Impacting Radiology Practices
2011
2011 Health Care Association of Michigan (HCAM) Spring Leadership Conference
How RAC & MIC Audits Will Affect LTC Facilities
2010
Michigan Bar Association Health Care Law Section Teleconference
The Audit Landscape for MI Providers & Suppliers
2010
Legal Lessons for Healthcare Professionals
Recovery Audit Contractors and Medicare Audits
2010
Decision Health Teleconference
Recovery Audit Contractors and Medicare Audits
2010
AHRA 38th Annual Meeting & Exposition
Recovery Audit Contractors and Medicare Audits
2010
2010 HCAM/MCAL Leadership Conference
How RAC and MIC Audits Will Affect LTC Facilities
2010
2010 Georgia Hospice and Palliative Care Organization Annual Leadership and Clinical Conference
Recovery Audit Contractors and Medicare Audits: Strategies for Successful Appeals
2010
10th Annual Michigan Osteopathic Association Practice Manager Program
RAC and Medicare Appeals: What Physicians Need to Know
2009
Oakland County Medical Society
Recovery Audit Contractors
2009
Michigan Association of Physicians of Indian Origin (MAPI)
Recovery Audit Contractors
Publications
2020
BC Advantage
AseraCare: Falsity and the False Claims Act
2019
2019
2019
2019
ABA The Health Lawyer
The Supreme Court Limits Agency Deference: Implications of Kisor v. Wilkie
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
The Department of Justice Softens its Stance on the Applicability of Federal Agency Guidance Documents
2018
BC Advantage
The Medicare Appeals Adjudication Backlog: New Intiatives May Offer Relief to Appelants
2018
BC Advantage
CMS Removes Total Knee Arthorplasty from the Inpatient-Only List
2017
ABA The Health Lawyer
edicare Appeals Adjudication Delay Update: Lawsuit Decided in Favor of Appellants (For Now)
2017
ABA The Health Lawyer
HHS Seeks to Improve Medicare Appeals Process
2016
ABA Health eSource
Be on NOTICE: CMS's Proposed Rule on the NOTICE Act Has Been Published
2016
2016
AHRA Link
New Final Rule on Medicare Overpayments
2016
ABA The Health Lawyer
Medicare Enrollment: CMS's Most Potent Program Integrity Tool Becomes Even Stronger
2016
ABA Health eSource
Reporting and Returning Medicare Overpayment: Long Awaited Final Rule Provides Clarification
2015
ABA Health eSource
Implications of the 2016 OPPS Final Rule: CMS Finalizes Revisions to its 2-Midnight Rule for Inpatient Hospital Admissions
2015
ABA Health eSource
Wading through Muddy Waters: Hospitals Plan for Revisions to CMS' 2-Midnight Rule
2015
ABA Health eSource
Healthcare Providers and Suppliers Eagerly Anticipate Planned Improvements to Recovery Audit Program
2015
AHRA Link
CMS Increases Enrollment Enforcement
2014
American Bar Association
What Are Medicare Appeals?
2014
BC Advantage
The Latest Development in Federal Health Care Audit Programs: Supplemental Medical Review Contractor Audits
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
American Case Management Association, Collaborative Case Management, Vol. 11, Issue 05
Hospitals Must Continue Implementation of Controversial 2-Midnight Rule
2014
ABA Health eSource
Partial Relief in Sight: CMS Proposes Settlement of Pending Inpatient Hospital "Status" Appeals
2014
2014
Legal Manual for New York Physicians, 4th Edition, Vol. 2
Medicare Audits of Physician Claims and the Medicare Appeals Process
2014
ABA The Health Lawyer
2-Midnight Rule Update: Hospitals Must Continue Implementation of the 2-Midnight Rule
2013
2013
Health Lawyers Weekly (AHLA)
CMS Publishes 2014 IPPS Final Rule: Revises Reimbursement Criteria Related To Patient Status
2013
2013
ABA Health eSource
The Latest Development in Medicare Audits: Supplemental Medical Review Contractor ("SMRC") Audits
2013
ABA Health Law Section
2014 IPPS Final Rule Establishes New Requirements for Physician Documentation in Hospitals
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?
2012
2011
Assocation of Healthcare Internal Auditors New Perspectives
Sleeping Giants: Compliance in the Age of Electronic Medical Records
2011
The Communique
Compliance Corner: Focus on Compliance
2011
2011
ABA Health eSource
The Future of the Recovery Audit Contractor Program
2011
Michigan Medical Law Report
Compliance Can Be Tricky in the Age of Electronic Medical Records
2010
The Communique
Breach Notification Final Rule
2010
Michigan Medical Law Report
Proposed HIPAA Regulations: What Physician Practices Need to Know
2010
Michigan Medical Law Report
HIPAA enforcement strengthened, penalties increased
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
Michigan Medical Law Report
Medicare eases rule on termination of provider medical records review
2009
Michigan Medical Law Report
Physicians Can Choose to Opt Out of Medicare Participation
2009
American 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?
2008
Journal of Health Care Compliance
Recovery Audit Contractors and Medicare Audits: Successful Strategies for Preparing for and Defending Audits
2008
The RAP Sheet, American Health Lawyers Association
The RACs Are Coming - Are You Ready?
2008
Michigan Medical Law Report
OIG Work Plan 2008: What can providers expect in 2008
2008
Michigan Medical Law Report
Can Medicare take my money? What the One-Time Notification means
2008
Anesthesia Business Consultants Communique
Compliance Corner: OIG Workplan 2008
2008
Caring, National Association of Home Care and Hospice
Recovery Audit Contractors and Medicare Audits: Successful Strategies for Defending Audits
2008
Radiology Business Journal
Recovery Audit Contractors and Medicare Audits: Successful Strategies for Defending Audits
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?
2007
Michigan Medical Law Report
Get ready for increased nationwide Medicare audit activity
2007
Michigan Medical Law Report
Legal issues impacting physician recruitment relationships
2007
Michigan Medical Law Report
DMC/WSU joint residency programs: Progress made, but work remains
2007
American Health Lawyers Association, Physician Organizations
The Medicare Appeals Process and Strategies for Successful Appeals
2007
HCCA Compliance Today
Get Ready: RACs may be nationwide sooner than expected!
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
Starting a Physician Practice in Michigan
2006
Michigan Medical Law Report
Legal issues impacting physician practices: Providing physical therapy services
Languages
English