Carole D. Christian

REPRESENTATIVE MATTERS

Ms. Christian represents health care clients in certificate of need hearings, court appeals, Medicaid appeals, Medicare reimbursement and similar negotiations and disputes with state and federal regulatory authorities.  She has 35 years of experience counseling hospitals, physicians, nursing homes and other providers of goods and services concerning contracts, fraud and abuse, licensing, medical staff matters, emergency treatment, medical records, withdrawal of treatment decisions and other patient care matters and acquisitions.

Ms. Christian has counseled clients extensively on new and emerging issues in health care regulation, including: compliance programs and codes of conduct; electronic medical records; and the Affordable Care Act.

• Comprehensive Home Health Services, Inc. v. Professional Home Health Care Agency, Inc., 434 SW3d 433 (2013) (establishing standards for conduct of certificate of need hearing following judicial remand) 
• Commonwealth v. Appalachian Regional Health Care, Inc., 606 SW3d 623 (Ky. App. 2019) (agreeing with lower court that the state Department of Medicaid Services’ method of paying for inpatient hospital care violated statutory mandate)
• Commonwealth of Kentucky v. Pediatric Specialists, PLLC, 579 SW3d 865 (Ky. App. 2018) (ruling in favor of physician group and rejecting Department of Medicaid’s effort to recoup money paid for services based on invalid audit and extrapolation)
• Northern Kentucky Mental Health Mental Retardation Regional Board, Inc. v. Commonwealth, Cabinet for Health & Family Services, 538 SW3d 298 (Ky. App. 2017) (ruling in favor of psychiatric hospital and affirming lower court decision that the state’s Medicaid payment methodology was illegal)
• Appalachian Regional Health Care, Inc. v. Coventry Health and Life Insurance Co., No. 5:12-114-KKC (E.D. Ky. Sept. 30, 2016) (ruling in favor of health system in dispute with Medicaid managed care company over out-of-network rates)
• Muhlenberg Community Hospital v. Muhlenberg Medical Properties VI, LLC, No. 2007-CA-002219 (Ky. App. 2009) (holding that physician group failed to satisfy criteria for exception to certificate of need law)