Kristen Pollock McDonald is a partner in the Atlanta office of Nelson Mullins Riley & Scarborough LLP and practices in the areas of healthcare and life sciences and government investigations.

Ms. McDonald focuses her litigation practice on healthcare litigation, including Federal and State False Claims Acts, OIG/DOJ investigations, commercial disputes between healthcare providers, defense of government audits, and appeals before federal and state administrative bodies. In addition, Ms. McDonald assists healthcare providers in general regulatory matters, including fraud and abuse analysis, corporate compliance programs, and HIPAA privacy and security regulations.

Representative Healthcare Litigation Matters include:

• Assist health care clients in OIG/DOJ civil fraud investigations involving billing and coding issues, billing and payment practices, medical necessity issues, kickbacks and other related issues
• Negotiate terms of corporate integrity agreements with the OIG
• Assist health care clients in Medicaid fraud investigations involving billing and coding issues, billing and payment practices, medical necessity issues, and other related issues
• Represent providers and suppliers in post-payment audits, including successful appeals of extrapolated overpayments in excess of $1 million
• Advise hospitals on responses to Joint Commission complaints and Quality Improvement Organization inquiries
• Represent providers in certification and licensure appeals
• Negotiate settlements with federal agencies involving civil money penalties and termination actions
• Represent healthcare providers in complex commercial disputes
• Represent healthcare providers in AAA arbitration disputes
• Represent clients in federal and state court mediations
• Participate in certificate of need appeals and assist clients in obtaining letters of non-reviewability

Representative Healthcare Compliance Matters include:

• Conduct due diligence reviews for private equity firms
• Conduct compliance reviews for healthcare entities
• Assist providers in implementing, revising, and evaluating the effectiveness of compliance programs
• Advise clients on CLIA regulations and compliance
• Advise healthcare entities on prompt pay and abandoned property statutes
• Draft formal requests for advisory opinions

Published court decisions include:

• U.S. ex rel. Yeager v. MedQuest Associates, Inc., et al., 2007 WL 3205285 (M.D. Ala., October 31, 2007) – succeeded in obtaining summary judgment for defendants in a False Claims Act qui tam action.
• U.S. ex rel. Parato v. Unadilla Health Care Center, Inc., et al., 2010 WL 146877 (M.D.Ga. January 11, 2010) – succeeded in obtaining partial dismissal of a False Claims Act qui tam action.

Ms. McDonald is admitted to practice in all Georgia State and Superior Courts; the U.S. Court of Appeals for the Eleventh Circuit; the U.S. District Court, Middle District of Georgia; and the U.S. District Court, Northern District of Georgia.

A speaker on healthcare legal topics, she recently presented “Patient Safety and Never Events,” which covered federal and state efforts to improve patient safety and reduce medical errors.  

She was named a “Rising Star” by Law & Politics and in Atlanta Magazine in 2010, 2007, and 2006.

A member of the American Bar Association and the American Health Lawyers Association, Ms. McDonald also is a member of the Georgia Academy of Healthcare Attorneys. She is a 2006 graduate of the Georgia 100 Program. A member of the United States Tennis Association, she participates in the Atlanta Lawn Tennis Association’s Business Women’s League.

Ms. McDonald earned a Juris Doctor from George Washington University Law School in 1998. While in law school, Ms. McDonald was a member of the Moot Court Board, participated in the international rounds of the Jessup Moot Court Competition, and was a Research and Writing Dean’s Fellow.  She earned a Bachelor of Arts, summa cum laude, Phi Beta Kappa, from the University of California-Los Angeles in 1995. During her undergraduate education in international economics, Ms. McDonald studied at Oxford University in England.