As both an attorney and a registered nurse, Ms. Fleming uses her first-hand experience to understand and strategically address her clients' most significant challenges.
Ms. Fleming is the leader of Baker Donelson's Health Care Regulatory team. She represents large hospital systems, skilled nursing facilities, clinical laboratories, home health agencies, hospice providers, behavioral health providers, assisted living facilities, physicians, and health care professionals. She focuses her practice on regulatory compliance; operations and risk management; Medicare and Medicaid reimbursement; Medicare and Medicaid audits and appeals; payor disputes and litigation; post-payment reviews; voluntary repayments; investigations and disclosures under the Centers for Medicare & Medicaid Services (CMS) and Office of Inspector General (OIG) self-disclosure protocols involving potential violations of the False Claims Act (FCA), Anti-Kickback Statute, and Stark Law; internal investigations involving allegations of health care fraud and retaliation under the FCA; medical staff matters; disciplinary proceedings and peer review; confidentiality of medical information; facility licensing; provider based regulations; 340B; scope of practice; professional licensing, and other health care issues involving state and federal law.
When clients need assistance with litigation, Ms. Fleming offers counsel at the trial and appellate levels, including jury and non-jury trials and hearings, such as administrative proceedings and appeals, in claims ranging from disciplinary proceedings, payor-provider disputes, and qui tam whistleblower actions. With respect to payor disputes, she has represented hospitals, health systems, behavioral health providers, home health providers, and hospice providers in payment disputes against payors including commercial health insurers and managed care organizations, Medicare managed care organizations, Medicaid managed care organizations, Medicare, and Medicaid.