Ashley Morgan, J.D.

Practice Concentration and Experience:

Ashley Morgan focuses her practice on regulatory health care compliance matters, fraud and abuse, and reimbursement issues. Ms. Morgan represents health care providers across the country in connection with a wide variety of health law issues including coverage disputes, documentation concerns, compliance, medical board complaints, and exclusion / termination issues. She has worked with an assortment of providers including dentists, home health companies, hospice agencies, pain management practices, primary care and specialty physicians, mental health professionals, physical therapists, and licensed acupuncturists.

Ms. Morgan is one of only a small percentage of health lawyers who has also trained and passed the certification examination requirements to become designated as a "Certified Professional Coder." On the billing side, she has also obtained her certification as a "Certified Medical Reimbursement Specialist." These skill sets have been invaluable when conducting GAP Analyses of a provider’s medical record documentation in order to determine whether the claims meet applicable Medicare, Medicare or private payor coverage and payment requirements. Ms. Morgan has handled claims disputes with major payors including Medicare, Medicaid, various BlueCross BlueShield entities, and UnitedHealthcare. She has extensive experience working on administrative appeals of large alleged extrapolated overpayments assessed by the Centers for Medicare and Medicaid Services’ (CMS) program integrity contractors -- primarily Unified Program Integrity Contractors (UPICs). She also represents health care providers and suppliers in connection with Comprehensive Error Rate Testing (CERT) audits, Supplemental Medical Review Contractor (SMRC) reviews and Medicare Administrative Contractor (MAC) "Targeted Probe and Educate" (TPE) reviews. Finally, Ms. Morgan has extensive experience representing our health care clients in connection with private payor audits and investigations by private payor SIUs.

In addition to her considerable experience handling government and private payor claims audits, Ms. Morgan also has successfully defended numerous licensed providers in connection with complaints and disciplinary proceedings brought against our clients by State Medical Boards, State Nursing Boards and other State Licensing Authorities. Ms. Morgan also has extensive experience representing providers in connection with state and federal fraud investigations.

In addition to her other certifications, Ashley Morgan is also a "Certified Medical Compliance Officer" and helps clients implement effective compliance programs and provides counsel on mandatory state and industry-specific policies and procedures. In this capacity, Ashley provides both remote and onsite reviews to review regulatory, OSHA and HIPAA compliance audits.