Kristen Gentry is a partner in the firm’s Health Law Practice Group, who focuses her practice on issues concerning Medicaid and Medicare program reimbursement. She has been involved in the design of Medicaid disproportionate share programs in Indiana and Michigan. She has also been instrumental in crafting Medicaid supplemental payment programs for a variety of health care providers, including hospitals, physicians, nursing facilities, dental clinics, and ambulance services. She was involved in the initial design and implementation of Indiana’s Medicaid non-state governmental nursing facility program and continues to be involved with the governmental hospitals and their acquisition of nursing homes.
Additionally, Kristen has been involved in the design and implementation of the Texas and Utah Medicaid non-state governmental nursing facility programs. She is currently involved in the design of a Medicaid Section 1115 DSRIP waiver program in Indiana. Kristen was a key player in the development of the Michigan Community Dental Clinics Medicaid non-state governmental dental clinic program, the Indiana and Michigan Medicaid physician supplemental payment programs, the Indiana hospital inpatient and outpatient hospital supplemental payment programs, and the recent Indiana Medicaid ambulance supplemental payment program.
Kristen has an in-depth knowledge of permissible billing practices for inpatient and outpatient facility billing (including psychiatric hospitals and outpatient providers) and “incident to” or “supervision” requirements for midlevel practitioners for both Medicare and Medicaid. She has also been involved in issues concerning chronic disease, chronic kidney disease, end-stage renal disease, and 340B program reimbursement; special state-funded disease coverage programs; and Medicaid outreach eligibility programs. She has worked with shared savings programs and dual-eligible chronic disease programs. She has an in-depth knowledge of the federal Medicare and Medicaid statutes.
Kristen also provides advice to health care providers for compliance with the AntiKickback Statute and Stark laws, “provider based” reimbursement, HIPAA, contracting, the Indiana Health Service, audits and general compliance, Medicare cost reporting issues and Provider Reimbursement Review Board appeals, and various other regulatory issues. She has also assisted as an outside contractor with audits of Medicaid managed care entities in Georgia and Kentucky, and has requested and received favorable Office of Inspector General advisory opinions for health care providers.
- Representing providers regarding general Medicaid reimbursement issues, including review of payment programs, appeals to managed care organizations, and appeals of audit findings.
- Represent governmental and other providers regarding State Medicaid supplemental, disproportionate share, Section 1115, and administrative claiming payment programs.
- Structuring of permissible intergovernmental transfer of funds (“IGTs”).
- Preparation, submission, and negotiation of Medicare Part A Cost Report Appeals to the PRRB.
- Requesting favorable Advisory Opinions from the Department of Health and Human Services, Office of Inspector General.
- Assisting providers with various other issues they have with state and federal health care agencies.
- Business Law for Health & Life Sciences
- Employee Benefits
- Long-Term Care
- Health & Life Sciences
- Hospitals & Health Systems
- Provider/Physician Groups
- Health Information Technology, Privacy & Security
Education and Honors
- Indiana University – Robert H. McKinney School of Law (J.D., 2002)
- Indiana University (B.S., with distinction, 1998)
- U.S. District Court, Northern District of Indiana
- U.S. District Court, Southern District of Indiana
Professional and Civic Activities
- American Bar Association (Member)
- American Health Lawyers Association (Member)
- Indianapolis Bar Association (Member)
- Executive Women in Health Care (Vice President of the Board)
- Indiana Benefits Conference (Member)
- Executive Women in Healthcare (Ex officious President and Board Member)
- American Heart Association, Go Red for Women (Executive Leadership Team)
- Selected for inclusion in the Indiana Super Lawyers®–Rising Stars 2013-2015 Editions