Abby Pendleton, Esq.
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Phone: (248) 996-8510
Fax: (248) 996-8525
29566 Northwestern Highway, Suite 200
Southfield, Michigan 48034
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.
Education
J.D. , Wayne State University Law School, Detroit, Michigan, 1996
Honors: Magna Cum Laude
Honors: Order of the Coif
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
Michigan, 1996U.S. District Court Eastern District of Michigan, 1996
Professional & Bar Association Memberships
State Bar of Michigan, Health Care Law Section
American Health Lawyers Association
Health Care Compliance Association
Medical Group Management Association
Michigan Medical Group Management Association
State Bar of Michigan Health Care Law Section Providers Subcommittee of the Substantive Law Committee
Published Works
"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., 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
"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
"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. Registration is free by sending an e-mail request.
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
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
