Kristin J. Jones

Associate

kjones@stradley.com

vCard
Kristin Jones

Overview

Kristin Jones provides regulatory, compliance and reimbursement counsel to health care providers (including hospitals, health systems and physician practices) and insurers. Kristin counsels clients who operate in a highly regulated environment and is skilled at providing practical advice about complex regulatory schemes.

She regularly advises clients on government-funded insurance programs such as Medicare and Medicaid, HIPAA and related state health information privacy and security laws, licensing laws, and regulatory strategies. She has experience drafting provider agreements, preparing insurance regulatory filings, and counseling insurers on federal compliance obligations under Medicare and Medicaid contracts. Kristin’s representation of healthcare providers includes providing guidance on the Anti-Kickback Statute, False Claims Act, Stark Law, patient safety and reporting obligations, and provider licensing laws. She has extensive experience analyzing physician compensation arrangements, compliance programs, reimbursement and billing, licensure, self-disclosure and reporting obligations, and other legal assessments and audits.

Kristin is an integral member of Stradley’s cybersecurity practice, advising clients in privacy and data security matters. Kristin works to protect clients before and after a data breach, from preparing privacy and security policies to swift guidance on responding to a data breach. Kristin understands the evolving security threats and the importance of protecting health information maintained by her clients.


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Representative Matters

  • defended physicians and other practitioners in multimillion dollar overpayment disputes with Medicare and other payors at all levels of administrative and judicial appeal
  • advised health care providers on out-of-network billing strategies and on other reimbursement and billing matters
  • interpreted the terms of state contracts for medical assistance programs including Pennsylvania HealthChoices (Medicaid), Community HealthChoices (long-term care), and Children’s Health Insurance Program and counseled managed care organizations on a myriad of issues arising from program terms
  • developed and implemented compliance plans, as well as individual policies and procedures, based on the Centers for Medicare and Medicaid Services and Office of the Inspector General regulations, federal and state law, and The Joint Commission requirements
  • advised health care clients on a variety of health information privacy and security matters, including breaches, HIPAA policies, and business associate agreements
  • counseled a lender financing health care facilities across the United States on health care regulatory matters such as changes of ownership and enrollment, state and federal audits of the target facilities, and obtaining a security interest in receivables under federal benefits programs
  • counseled clients on e-discovery and record retention issues, especially involving the collection, review and production of documents containing health information protected by HIPAA
  • defended health care providers and DME-POS suppliers in Medicare/Medicaid appeals at all levels, starting with the receipt of an audit request through federal court appeals
  • analyzed business deals and specialty services - from insurance offerings to student health services to financing opinions - to counsel clients on the impact of federal and state health care laws and regulations
  • defended pharmaceutical companies and medical device manufacturers in products liability matters, including medical causation and product identification issues and mass tort litigation
  • analyzed the effect of various components of the Affordable Care Act as applied to both providers and payors

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Credentials

Bar Admissions
  • New Jersey
  • Pennsylvania
Court Admissions
  • Pennsylvania Supreme Court
  • U.S. District Court for the Eastern District of Pennsylvania
  • U.S. District Court for the District of New Jersey
Education
  • J.D., cum laude, Temple University Beasley School of Law
  • B.A., Brown University
Memberships

  • American Health Lawyers Association

Speaking Engagements

  • Presenter, “Ethical Obligations of Counsel in the Wake of a Data Breach,” Association of Corporate Counsel Greater Philadelphia/Delaware Valley Chapter 
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In The Community

Kristin is active in the Philadelphia community. She is dedicated to assisting the local chapter of the American Red Cross and, in furtherance of those efforts, acts as a member of the Donor Recruitment Committee, co-chair of Legal Initiative and co-chair of the Stradley Ronon Blood Drive Committee.
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