Kevin R. Miserez is an associate in the Health Sciences Department of Pepper Hamilton LLP, resident in the Detroit office.
Mr. Miserez has represented a wide range of health care provider types and related organizations nationwide, including physicians and non-physician practitioners, physician and non-physician practitioner group practices, clinical laboratories, pharmacies, ambulatory surgery centers, skilled nursing facilities, hospices, home health agencies, DMEPOS suppliers, ambulance suppliers, substance abuse treatment centers, independent diagnostic testing facilities, hospitals, management service organizations, and health care private equity investors.
Mr. Miserez practices in all areas of health care law and has significant experience advising clients on a variety of complex regulatory and transactional matters involving federal and state fraud and abuse laws (including the federal Anti-Kickback Statute, federal Stark Law, False Claims Act liability, and state kickback/fee-splitting and self-referral laws), corporate practice of medicine, HIPAA and state privacy laws, physician/hospital arrangements, telemedicine, concierge and private pay medicine, and scope of practice issues.
Mr. Miserez also has unique experience in representing clients in connection with their third-party payor relationships. He counsels and represents clients in all aspects of provider enrollment and credentialing, including initial enrollment filings, revalidations, physician opt-outs, changes in ownership and other mandatory disclosures, and appealing adverse enrollment determinations (e.g., revocations, denials, and effective date determinations). He also advises health care providers on a variety of compliance issues concerning Medicare, Medicaid, and other third-party payor billing and reimbursement requirements.