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MichaelScott-Kristansen

Special Counsel

Overview

Biography

Michael focuses his practice on representing health care and human services providers in a wide range of litigation and compliance matters. 

He regularly advises clients on matters involving audits and investigations, reimbursement and billing, conditions of participation, regulatory compliance and enforcement, HIPAA compliance and breach investigations, insurance and payor disputes, licensing and professional discipline, and debt collection.

Michael prosecutes and defends lawsuits on behalf of health care and human services providers and administrative hearings involving the Centers for Medicare & Medicaid Services, the Department of Health, the Office of the Medicaid Inspector General, the Office of Professional Medical Conduct, the Office of Professional Discipline, and other administrative bodies concerning reimbursement, overpayments, compliance, conditions of participation, and licensing matters.

Bar Associations

  • New York State Bar Association, Health Law Section, Member
  • Monroe County Bar Association
Experience

Representative Experience

  • Led the defense of multiple year-long investigations by the Office of the New York State Attorney General into various nursing homes' responses to the COVID-19 pandemic.
  • Successfully negotiated six-figure settlements with managed care plans on behalf of long-term care and adult care facilities for wrongfully denied claims and delayed payments. 
  • Obtained a 95 percent reduction in the recoupment and penalty for a medical billing service targeted by the Medicaid Fraud Control Unit for allegations of fraudulent billing.
  • Successfully prosecuted administrative appeals in cases of first impression concerning Medicaid documentation requirements for long-term care providers, which served as the basis for overturning over two dozen OMIG final audit reports.

Prior Experience

  • Pullano & Farrow PLLC, Associate
  • Hurwitz & Fine, PC, Associate

Selected Community Activities

  • Mary M. Gooley Hemophilia Center, Board of Directors, Chairperson

Selected Honors

  • Selected to Super Lawyers Upstate New York Rising Stars: Health Care, 2017–2021
  • Healthcare Business Academy, Fellow, 2017
  • New York Daily Record, Up & Coming Attorneys, 2017
Knowledge

Selected Speaking Engagements

Selected Publications & Media

Featured Media

Alerts

Second Department Finds Transcripts of Lack of Appearance for EUOs Not Admissible as Business Records

Alerts

Important Developments From the Most Recent NYS Cannabis Control Board Meeting

Alerts

Mandatory Proof of Vaccination and Use of ArriveCAN to Enter Canada to End on September 30, 2022. Will the United States Follow Suit?

Alerts

NYS Submits 1115 Waiver Amendment (Health Equity Reform) to CMS

Alerts

Federal Court Sanctions Party Where Corporate Representative Answered "I Don't Know" over 100 Times During 30(b)(6) Deposition

Alerts

COVID-19 Business Interruption Update: Second Circuit Issues Decisions in Favor of Insurers Dismissing Claims

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