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MichaelScott-Kristansen

He | Him | His

Special Counsel

"I believe that open dialogue and a mutual willingness to learn are at the heart of every successful attorney-client relationship."

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, Long-Term Care Committee and Litigation Committee, Member
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, 2017–2024
  • Healthcare Business Academy, Fellow, 2017
  • New York Daily Record, Up & Coming Attorneys, 2017
Knowledge

Selected Speaking Engagements

  • 45th Annual Association for Community Living Agencies in Mental Health (ACLAIMH) Conference, "Lawsuits, Audits, Investigation, and Other Legal Threats: Be Prepared for Your Next Legal Challenge," Co-Presenter
  • LeadingAge 2022 Annual Meeting, "Getting Paid: Best Practices to Avoid Non-Payment"
  • Estate Planning Council of Rochester, “Medicare, Medicaid & Health Care Cost Considerations During Retirement”
  • Rochester Business Journal, “Business Focus First 100 Days”

Selected Media

Selected Alerts & Blog Posts

Featured Media

Alerts

Natural Gas Bans in New York State Take Shape: Exemptions and Lawsuits Under Scrutiny

Alerts

Here We Go Again: Second Circuit Makes Additional Certification Attempt Regarding the New York Foreclosure Abuse Prevention Act

Alerts

OMIG Launches Enhanced Audit Protocol Page: Key Compliance Resource for Medicaid Providers

Alerts

Website Accessibility Lawsuits: Several "Tester" Plaintiffs—Simon Isakov, Xinyue Hippe, Constance Henry, Morgan Cole, Amelia Cazares, and Leah Walker—Targeting Businesses in Recent Flurry of Lawsuits

Alerts

Website Accessibility Lawsuits: Several "Tester" Plaintiffs—Melchion Wee-Ellis, Dennis Sumlin, Tammy Hampton, Haron Cole, Debbie Pittman, and James Evans—Targeting Businesses in Recent Flurry of Lawsuits

Alerts

New York Appellate Divisions Split on Whether an Assisted Living Facility May Operate as a De Facto Residential Health Care Facility

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