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Lisa Carlson

Associate

800 W. Main Street, Suite 1750, Boise, ID 83702

Lisa provides healthcare and life sciences clients with practical and results-oriented solutions that prioritize regulatory compliance and risk mitigation strategies.

Lisa’s experience encompasses a wide array of regulatory issues affecting hospitals and health systems, healthcare providers and suppliers, health insurers, and healthcare industry investors.

As a former in-house attorney for a major health system, Lisa has a deep understanding of the compliance, administrative, and litigation issues her clients may face. This experience shapes the proactive and collaborative approach she takes in assisting clients navigate healthcare transactions and business initiatives that raise complex regulatory issues. As a fourth-generation Idahoan, Lisa is keenly aware of the evolving priorities and compliance issues facing healthcare providers in Idaho.

Lisa advises on federal and state anti-kickback statutes, federal and state self-referral prohibitions (Stark law), the False Claims Act, HIPAA, participation and billing requirements for Medicare and Medicaid, 340B, corporate practice of medicine and fee-splitting restrictions, and professional licensing and credentialing.

Experience

Lisa advises clients on regulatory and compliance issues, including:

  • Federal and state fraud and abuse laws
  • HIPAA
  • Medicare, Medicaid reimbursement and enrollment rules
  • Professional licensing and credentialing
  • Corporate practice of medicine, dentistry, veterinary medicine

Life Sciences Law:

  • CLIA certification and compliance
  • Anatomical gifts, laws, and regulations
  • Food and Drug Administration (FDA) laws and compliance
  • 340B drug program compliance and contracting
  • Drug diversion and controlled substances

Other healthcare experience includes:

  • Direct primary care models
  • Payor agreements
  • Disputing NPDB reports
  • HHS exclusions and reinstatements
  • Credentials hearings and peer review
  • Due diligence on healthcare businesses
  • Federal and state administrative hearings

Client Results

  • Counseling healthcare providers to comply with federal and state rules and regulations, including: HIPAA, Anti-Kickback, Stark, fee-splitting, corporate practice of medicine, beneficiary inducement

  • Assisting healthcare insurers with Medicare and Medicaid rules, state insurance licensing and market conduct laws, and Medicaid managed care requirements
  • Advising on 340B compliance, HRSA audits, responses to manufacturer inquiries, and negotiation of contract pharmacy arrangements

  • Structuring direct primacy care business models

  • Responding to and defending against federal and state government investigations, surveys, and complaints
  • Negotiating and drafting of independent contractor, employment, partnership, nondisclosure, affiliation, sponsorship, and service agreements

  • Representing healthcare providers with billing and reimbursement disputes, including Provider Reimbursement Review Board (PRRB) appeals

  • Advising on physician credentialing, peer review, and HCQIA compliance

  • Providing guidance on governance issues related to charitable donations and health foundations

  • Advising in pre-litigation and risk mitigation

Industries

News

Publications

Speaking Engagements

Education

Bar Admissions

Court Admissions

Recognition

  • Best Lawyers: Ones to Watch, Corporate Law, 2021

Professional and Civic Affiliations

  • American Health Lawyers Association, Member
  • Idaho Bio Alliance of Medicine, Board Member
  • Ballet Idaho, Member of Board of Directors
  • Idaho State Bar, Idaho Academy of Leadership for Lawyers, Class of 2020-2021
  • Idaho State Bar, Health Care Section, Vice-Chair
  • Idaho State Bar, Business & Corporate Law Section, Member
  • Idaho Women Lawyers, Former Member of Board of Directors, Current Member
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