Profile
Kimberly A. Lammers provides legal advice to a broad range of health care clients, including multi-state health systems, academic medical centers, community hospitals, critical access hospitals, independent laboratories, pharmacies, telehealth providers, and specialty providers, including organizations that furnish home-delivered meal services, transition of care services, and remote patient monitoring services. Kim has a wealth of practical experience in a wide range of operational issues, having practiced in the area of health care law exclusively over her twenty-year career, including spending over a decade working in-house for a multi-state health system in the areas of legal, compliance, and revenue cycle.
Kim specializes in regulatory compliance matters, including Medicare and Medicaid reimbursement issues and fraud and abuse laws. She frequently prepares corrective action plans to address survey deficiencies issued under the hospital Conditions of Participation, Clinical Laboratory Improvement Amendments (“CLIA”), and the Emergency Medical Treatment and Labor Act (“EMTALA”); creates compliance policies and processes, including policies for billing compliance and clinical documentation improvement programs; conducts compliance program effectiveness evaluations; manages peer review and risk management issues; and addresses credentialing and Medical Staff issues, including performance improvement plans, disciplinary actions, hearings and appeals, and reporting to licensure boards and the National Practitioner Data Bank (“NPDB”).
She also assists clients with responding to incidents of drug diversion and governmental investigations related to compliance with the Controlled Substances Act; making self-disclosures and voluntary refunds of potential overpayments; responding to requests for recoupments and repayments from governmental contractors and the integrity units of third-party payors; appealing adverse payment, reimbursement, and enrollment determinations, including at the Administrative Law Judge, Departmental Appeals Board, and Provider Reimbursement Review Board levels; and responding to allegations of fraudulent billing, the provision of medically unnecessary services, or failure to meet regulatory standards of the Centers for Medicare and Medicaid Services, the Office of Inspector General, the Food and Drug Administration’s Mammography Quality Standards Act, state Medicaid agencies, state Attorneys’ General offices, and state Medicaid Fraud Control Units.
She prepares and negotiates contracts for all types of services and operational functions, including coding, billing, medical records, and other “back room” health care administrative functions; clinical and professional services agreements; physician and advanced practice provider employment agreements; hospital-based physician services agreements; and managed care agreements.
Kim is licensed in Iowa, Nebraska, South Dakota, and Wisconsin. She is also a Certified Professional Coder through the American Academy of Professional Coders (“AAPC”) and has completed ICD-10 proficiency testing. She is a member of the Iowa State Bar Association, Nebraska State Bar Association, South Dakota State Bar Association, Wisconsin State Bar Association, American Health Law Association, Health Care Compliance Association, and the Iowa Society of Healthcare Attorneys.
Kim received her law degree from Creighton University School of Law, summa cum laude, and received her undergraduate degree from the University of South Dakota, magna cum laude, with University honors
Areas of Practice
Education
- Creighton University School of Law, J.D., summa cum laude, 1997
- University of South Dakota, B.A., Political Science and Classics, magna cum laude, 1994
Bar & Court Admissions
- Nebraska, 1997
- Iowa, 2005
- South Dakota, 2019
- Wisconsin, 2019
Professional & Civic Affiliations
- American Health Lawyers Association, Member
- Health Care Compliance Association, Member
- American Academy of Professional Coders, Certified Professional Coder