Abby Pendleton, Esq.
Founding PartnerThe Greenberg, Dresevic, Iwrey, Kalmowitz & Pendleton Law Group
The Health Law Partners
1979 Marcus Avenue, Suite E100
Lake Success, NY 11042
(tel) 212-734-0128
(fax) 917-210-2952
590 Madison Avenue, 18th Floor
New York, NY 10022
(tel) 212-734-0128
(fax) 917-210-2952
The Health Law Partners, P.C.
29566 Northwestern Highway
Ste. 200
Southfield, MI 48034
(tel) 248-996-8510
(fax) 248-996-8525
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) and State Bar of New York (Member, Health Law Section); the American Bar Association; the American Health Lawyer's Association; the Health Care Compliance Association; the Medical Group Management Association and the Michigan Medical Group Management Association.
Education
J.D. , Wayne State University Law School, Detroit, Michigan, 1996
Honors: Magna Cum Laude
Honors: Order of the Coif
Honors: Law Review: Wayne Law Review Senior Articles Editor
Honors: Recipient of the Deloitte and Touche LLP Award for Tax Law
B.S.B.A , Central Michigan University, Mount Pleasant, Michigan, 1993
Honors: Cum Laude
Major: Finance
Jurisdictions Admitted to Practice
MichiganNew York
U.S. District Court Eastern District of Michigan
Professional & Bar Association Memberships
State Bar of Michigan
Health Care Law Section
American Health Lawyers Association
Health Care Compliance Association
American Bar Association
Medical Group Management Association
State Bar of Michigan Health Care Law Section Providers Subcommittee of the Substantive Law Committee
Past Chair
State Bar of Michigan, Health Care Council
Member
New York State Bar Association
Health Law Section
Published Works
"Anesthesia Practices Should Prepare for More Audit Activity", by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Communique, Winter 2011.
" Sleeping Giants: Compliance in the Age of Electronic Medical Records", by Ranjan Sachdev, MD, MBA, CHC, Abby Pendleton, Esq., and Jessica L. Gustafson, Esq., Association of Healthcare Internal Auditors New Perspectives, Winter 2011.
"The Future of the Recovery Audit Contractor Program", by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., ABA eSource, August 2011
Compliance Can Be Tricky in the Age of Electronic Medical Records, by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Michigan Medical Law Report, Spring 2011.
"The Recovery Audit Contractor ("RAC") Program: What Can Laboratories and Pathologists Expect?", by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., G-2 Compliance Report, February 2011.
"Compliance Corner: Focus on Compliance," by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Communique, Fall 2010.
"RAC Program Proposed Rule Published," by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Michigan Medical Law Report Winter 2011.
"The OIG's New Roadmap on Avoiding Fraud and Abuse," by Stephanie P. Ottenwess, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report Winter 2011.
“Proposed HIPAA Regulations: What Physician Practices Need to Know,” by Abby Pendleton, Esq., Jessica L. Gustafson, Esq., and Stephanie Ottenwess, Esq., Michigan Medical Law Report Fall 2010.
"Health care reform measures, increased audit scrutiny, and more reasons why compliance programs matter," by Abby Pendleton, Esq. and Kathryn Hickner-Cruz, Esq., Michigan Medical Law Report, Vol. 6, No. 2, Summer 2010. p.12
"The Anesthesia Community Must Be Prepared for Increased Audit Activity by RACS and Others," by Abby Pendleton, Esq., Communique, Spring 2010.
"AHLA Deciphering Codes: Fraud & Abuse for Coders and Coding Insight for Healthcare Lawyers," a chapter in the AHLA/AAPC Coding Manual, Abby Pendleton, Esq., published in 2010.
"Breach Notification Final Rule," by Jessica L.Gustafson, Esq. and Abby Pendleton, Esq., The Communique, Winter 2010.
"HIPAA enforcement strengthened, penalties increased," by Jessica L.Gustafson, Esq. and Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 5, No. 4, Winter 2010.
"The RAC Program: What Can Radiology Providers Expect as RACs Begin Auditing?," by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Radiology Management, November/December 2009.
"Physicians Can Choose to Opt Out of Medicare Participation," by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Michigan Medical Law Report, Vol. 5, No. 3, Fall 2009.
"HITECH in a High Tech Era," by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Communique, Fall 2009.
"What Anesthesiologists And Pain Management Physicians Need To Know About The RAC Program," by Abby Pendleton, Esq. and Jessica Gustafson, Esq., Communique, Summer 2009.
"Medicare eases rule on termination of provider medical records review," by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Michigan Medical Law Report, Vol. 5, No. 1, Spring 2009
"Recovery Audit Contractors And Medicare Audits: What Can Hospitals and Health Systems Expect as the RAC Program Expands Nationwide?,” co-authored: Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., American Health Lawyers Association, Hospitals and Health Systems Practice Group Member Briefing, January 2009.
"Get Ready -- Recovery Audit Contractors Are Coming to Michigan," co-authored: Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Michigan Medical Law Report, Vol. 4, No. 4, January 2009
"RAC to the Future: What Can Medicare Providers and Suppliers Expect from the Recovery Audit Contractor Program?," co-authored: Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., The Health Lawyer, The ABA Health Law Section, Vol. 21, No. 2, December 2008
"The RACs Are Coming - Are You Ready?" co-authored: Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., The RAP Sheet, American Health Lawyers Association, December 2008
"Recovery Audit Contractors and Medicare Audits: Successful Strategies for Defending Audits," co-authored: Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Caring, National Association of Home Care and Hospice, November 2008
"Planning for Compliance," by Abby Pendleton, Esq. and Adele P. Jorissen, Esq., Anesthesia Business Consultants Communique, Fall 2008
"Can Medicare take my money? What the One-Time Notification means," by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Michigan Medical Law Report, Vol. 4, No. 2, Summer 2008
"Compliance Corner: OIG Workplan 2008," by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Anesthesia Business Consultants Communique, Spring 2008
"OIG Work Plan 2008: What can providers expect in 2008?" by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Michigan Medical Law Report, Vol. 4, No. 1, Spring 2008
"Is Medicare being billed the right way? Here's how to avoid the risks," by Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 3, No. 4, Winter 2008
"Get Ready: RACs may be nationwide sooner than expected!" co-authored: Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., HCCA Compliance Today, Vol. 9, No. 10, October 2007
"Get ready for increased nationwide Medicare audit activity," co-authored: Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Michigan Medical Law Report, Vol. 3, No. 3, Fall 2007
"Legal issues impacting physician recruitment relationships," by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Michigan Medical Law Report, Vol. 2, No. 4, Winter 2007
"What all physicians need to know about the proposed changes to the Medicare physician fee schedule," by Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., Michigan Medical Law Report, Vol. 2, No. 3, Fall 2006
"3 Cost-Effective Compliance Tips to Jump Start Your Compliance Efforts," by Abby Pendleton, Esq., Communique, Fall 2006
"Prescribing controlled substances: What every physician should know," by Abby Pendleton, Esq. and Robert S. Iwrey, Esq., Michigan Medical Law Report, Vol. 2, No. 2, Summer 2006
"The New Medicare Part A and Part B Appeals Process," co-authored: Abby Pendleton, Esq., Health Law Handbook 2006, Part I, Chapter I, 2006
"The Michigan Social Security Number Privacy Act, new whistleblower provisions of the Michigan Medicaid False Claims Act and more," co-authored: Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 2, No. 1, Spring 2006
"Billing: Three key compliance tips that every physician should implement," co-authored: Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 1, No. 4, pg. 5, 10, Winter 2005
"Compliance Auditing: Three Key Issues That Every Physician Should Consider," co-authored: Abby Pendleton, Esq., Michigan Medical Law Report, Vol. 1, No. 3, Fall 2005
"The New Medicare Appeals Process," co-authored: Abby Pendleton, Esq., The Health Lawyer, The ABA Health Law Section, Vol. 17, No. 3, June 2005
"Third-Party Payor Audits: The Impact on Anesthesia Groups," co-authored: Abby Pendleton, Esq., Anesthesia Business Consultants Communique, Fall 2004
"Third-Party Payor Audits: Impact on Physician and Healthcare Provider Clients," co-authored: Abby Pendleton, Esq., Laches, July 2004
"Medicare Appeal and Recovery Reforms under the Medicare Prescription Drug, Improvement and Modernization Act of 2003," co-authored: Abby Pendleton, Esq., The Health Lawyer, The ABA Health Law Section, March 2004
"Have you Engaged in Compliance Activities Lately?" co-authored: Abby Pendleton, Esq. and Robert S. Iwrey, Esq., MSA Ventilator, December 2003
"Final HIPAA Security Rule Allows Greater Flexibility," co-authored: Abby Pendleton, Esq., The Health Lawyer, The ABA Health Law Section, April 2003
"New HIPAA Privacy Guidance Reduces ASC Fears," co-authored: Abby Pendleton, Esq., FASA Update: Journal of the Federated Ambulatory Surgery Association, Volume XX, Number 1, January/February, 2003
"Proactive Compliance as an Audit Defense Strategy,” by Abby Pendleton, Esq. and Robert S. Iwrey, Esq., The Ventilator, January 2002
"Cpt 2000: Pain Management Coding Compliance," co-authored: Abby Pendleton, Esq., Anesthesia Business Consultants Communique, Winter, 2000
"OIG Softens its Overall Approach in Releasing the Final Compliance Guidance for Individual and Small Group Physician Practices," co-authored: Abby Pendleton, Esq., The Health Lawyer, The ABA Health Law Section, October 2000
"OIG Issues Draft Compliance Guidance for Individual and Small Group Physician Practices," co-authored: Abby Pendleton, Esq., The Health Lawyer, The ABA Health Law Section, June 2000
"Hospice Providers are Well Advised to Address OIG Identified Hospice Risk Areas," co-authored: Abby Pendleton, Esq., Health Care Weekly Review, February 2000
"OIG Issues Special Advisory Bulletin on Gainsharing Arrangements," co-authored: Abby Pendleton, Esq., Anesthesia Business Consultants Communique, Fall 1999
"Continuing Education is Key to Compliance," co-authored: Abby Pendleton, Esq., Anesthesia News, November 1999
"OIG Issues Compliance Guidance for the Hospice Industry and Medicare + Choice Organizations," co-authored: Abby Pendleton, Esq., The Health Lawyer, The ABA Health Law Section, October 1999
"HCFA Issues Final Rule on Medical Direction," co-authored: Abby Pendleton, Esq., Anesthesiology News, November/December 1998
"HIPAA Security Workbook and Toolkit," co-authored: Abby Pendleton, Esq., FASA
"HIPAA Privacy Workbook and Toolkit," co-authored: Abby Pendleton, Esq., FASA
"Anesthesia Time: Compliance Tips," co-authored: Abby Pendleton, Esq., Anesthesia Business Consultants Communique
"HIPAA Security Workbook and Toolkit," co-authored: Abby Pendleton, Esq., United Communications Group
"HIPAA Privacy Workbook and Toolkit," co-authored: Abby Pendleton, Esq., United Communications Group
Speaking Engagements
“The Medicaid RAC Final Rule: What Legal Counsel Representing Healthcare Providers Need to Know,” by Jessica L. Gustafson, Esq. and Susan Emanual, moderated by Abby Pendleton, Esq., an American Health Lawyers Association Webinar, January 25, 2012.
“Covenants Not to Compete in the Michigan Health Care Marketplace,” by Thomas W. H. Barlow, Esq. and moderated by Abby Pendleton, Esq., State Bar of Michigan Health Care Law Section Teleconference, June 1, 2011.
“The Michigan Audit Landscape: Medicare, Medicaid, and Private Payor Audits,” by Jessica L. Gustafson, Esq. and Connie Blachut, MPH, MBA, moderated by Abby Pendleton, Esq., State Bar of Michigan Health Care Law Section Teleconference, June 15, 2011.
“ZPICs, RACs, MICs and More: What Radiology Practices Need to Know about Federal Auditing Programs,” Abby Pendleton, Esq. and Jessica L. Gustafson, Esq., AHRA Annual Meeting and Exposition, August 17, 2011, Grapevine, TX.
"The Current Audit Landscape, Is Your Organization Prepared?" Abby Pendleton, Esq., NYSARC, May 10, 2011, Albany, NY.
“The Compliance Landscape for Chronic Pain” by Abby Pendleton, Esq. and Neda Mirafzali, Esq., Advanced Techniques for Acute and Chronic Pain Management 2011, May 1, 2011, Detroit, MI
“The Fraud and Abuse Environment for Anesthesiologists,” Abby Pendleton, Esq., Anesthesia Business Consultants, LLC, Tulane University School of Medicine Department of Anesthesiology & The Center for Continuing Education Tulane University Health Sciences Center, April 26, 2011, Webinar.
"Compliance in the Age of Electronic Health Records," Health Care Compliance Association's 15th annual Compliance Institute, April 10-13, 2011 Orlando, FL.
Legal Issues Regarding Difficult Pain Patients: Noncompliance, Drug testing and terminating physician/patient relationships, Abby Pendleton, Esq., MGMA AAA Conference, March 20, 2011 in Baltimore, MD.
"Navigating Claim Denials," World Research Group Panel Discussion, March 2, 2011.
“OIG’s Roadmap for New Physicians,” Abby Pendleton, Esq., Glenn Martin, Esq., and Linda Baumann, Esq., ABA Health Law Section Webinar, December 10, 2010.
“What’s New In Compliance: Mandatory compliance plans, False Claims Act enforcement (refunds of overpayments, EHR compliance risks),” Abby Pendleton, Esq., Anesthesia Business Consultants’ Anesthesia and Pain Medicine Update for 2011 Webinar, December 10, 2010.
"Society for Pain Practice Management Billing and Coding Workshop," September 23-26, 2010.
"Recovery Audit Contractors and Medicare Audits," The Association for Medical Imaging Management (AHRA) 38th Annual Meeting & Exposition, August 22-26, 2010.
"Recovery Audit Contractors: Is Your Organization Ready for the RAC Attack?" American Association of Nurse Anesthetists (AANA) Annual Meeting, August 11, 2010, Seattle, WA.
"RAC Attack," The Medical Group Management Association 2010 Anesthesia Administration Assembly Conference, May 24-26, 2010, San Antonio, TX.
"RAC and Medicare Appeals: What Physicians Need to Know," The Michigan Osteopathic Association 10th Annual Michigan Osteopathic Association Practice Manager Program, May 13-14, 2010.
"The Audit Landscape for Michigan Providers and Suppliers," Michigan Health Care Law Section Teleconference, March 18, 2010.
"Audits, Refunds, Denials, Appeals And All The Other Things That Can Sink Your Practice!" "Medicare and Third Party Payor Audits," "Focus on Compliance 2010," and "HIPAA, HITECH Act, Identity Theft, and Breach Notification - Practical Action Steps for the Pain Practice," Society for Pain Practice Management 23rd Annual Pain Management Symposium February 27-March 3, 2010.
"Recovery Audit Contractors and Medicare Audits: Strategies for Successful Appeals," 2010 Georgia Hospice and Palliative Care Organization Annual Leadership and Clinical Conference, February 25, 2010.
"Recovery Audit Contractors and Medicare Audits," Decision Health Teleconference, February 18, 2010.
"Recovery Audit Contractors and Medicare Audits," United Physicians-National City Partnership, January 20, 2010.
"Managing the RAC Appeals Process," A World Research Group Healthcare Management Conference: Reducing RAC and MIC Audit Exposure, December 7 through 8, 2009.
"Recovery Audit Contractors and Medicare Audits: Lessons Learned and the Road Ahead," 2009 American Health Lawyers Association Fraud and Compliance Forum, October 4 through 6, 2009 (with co-presenters Don Romano, attorney and Connie Leonard, Director, CMS Division of Recovery Audit Operations).
"The New Environment for Fraud and Abuse Enforcement for Anesthesia & Pain Management," Anesthesia Business Consultants Webinar, August 20, 2009.
Recovery Audit Contractors 'RAC' Program and Successful Strategies for Appeal, The Association for Medical Imaging Management (AHRA) 2009 Annual Meeting and Exposition, August 9-13
Managing the RAC Appeals Process, World Research Group Healthcare Management Conference, August 3-4, 2009
Recovery Audit Contractors, Michigan Association of Physicians of Indian Origin (MAPI), March 15, 2009
Recovery Audit Contractors and Medicare Audits, National Hospice & Palliative Care Organization (NHPCO), October 24, 2008
The Medicare Appeals Process and Strategies for Successful Appeals, Michigan Home Health Association (MHHA), May 14, 2008
Billing Coding and Compliance, Society for Pain Practice Management (SPPM), July 20, 2007 - July 22, 2007
The Future of Healthcare, BOC Athletic Trainer Regulatory Conference, July 12, 2007 - July 13, 2007
Compliance Program Challenges & Opportunities (Panel Member), Health Care Compliance Association, June 15, 2007
Third Party Payor Audits, American Society of Addiction Medicine (ASAM), April 26, 2007 - April 29, 2007
Billing, Avoiding Malpractice, SPPM, March 10, 2007 - March 14, 2007
Multiple Topics, SPPM, January 20, 2007 - January 21, 2007
The New Medicare Appeals Process, Annual Meeting of the Medical Group Management Association (MGMA), October 25, 2006
Fraud and Abuse Compliance Issues, United Communications Group Physicians National Summit, September 14, 2006 - September 16, 2006
Key Legal Compliance Issues Facing Skilled Nursing Facilities, Healthcare Association of Michigan (HCAM), 2006
How to Keep your DME Relationships Problem-Free, United Communications Group, 2006
Medicare Appeals, Exclusive Contracts, Compliance, Legal Risks of Facility Ownership, Society for Pain Practice Management, 2005
State Laws and Regulations (Current Trends & Implications to AMCs) (Panel Member), NC NICA 3rd Academic Medical Center Conference, 2005
Operationalizing HIPAA Privacy and Security, Society for Pain Practice Management, 2005
Top Five Clauses to Watch Out for in Private Payer Contracts, Decision Health's Private Payer Contract Solutions Conference, 2005
Understanding the Basics of HIPAA, ICLE 11th Annual Health Law Institute, 2005
Practical Steps to HIPAA Compliance for Ambulatory Surgery Centers, Federated Ambulatory Surgery Association 2003 Annual Meeting, 2003
HIPAA Compliance, Medical Group Management Association (MGMA) Anesthesia Administration Assembly 2003 Conference in Montreal, Canada, 2003
HIPAA, United Communications Group, October 1, 2003 - October 3, 2003
HIPAA, United Communications Group, April 11, 2003
Anesthesia Billing Compliance, United Communications Group Anesthesia Conference, January 23, 2003 - January 24, 2003
HIPAA Compliance, United Communications Group, January 30, 2002 - February 1, 2002
Anesthesia Compliance, Medical Group Management Association (MGMA)
Anesthesia Administration Assembly 2002 Conference, 2002
How to Boost Compliance in your Pain Practice, United Communications Group, October 22, 2001 - October 23, 2001
Documentation and Monitoring of a Compliance Program, United Communications Group, July 23, 2001 - July 24, 2001
HIPAA Privacy Rule, United Communications Group, April 1, 2001
Compliance for Pain Management Physicians, United Communications Group, January 1, 2001 - April 1, 2001
Medicare & Medicaid: Enforcement, Compliance and the Transition to Managed Care in Michigan ("Developing and Implementing a Compliance Program"), Lorman Education Services, 1999 - 2000
How to Boost Compliance in your Pain Practice, United Communications Group, 1999 - 2000
Development and Implementation of Compliance Programs for Anesthesia Practices, United Communications Group, November 1, 1999
Honors and Awards
Michigan Lawyers Weekly, Women in the Law, 2011.
D'Business Magazine Top Lawyer in Healthcare Law 2011
American Jurisprudence Book Awards in Contracts and Criminal Law, 1996
Deloitte & Touche LLP Award for Tax Law, 1996
Past Employment Positions
Wachler & Associates, P.C., associate, partner, 1996-2009
Wachler & Associates, P.C., law clerk, 1994-1996
