Susan V. Kayser

Representative Matters

Compliance, Audits and Enforcement

• Obtained on behalf of a physician a decision relieving the client of a demanded $700,000 in Medicare overpayment obligation under the Centers for Medicare & Medicaid Services (CMS) Victimized Provider Project and Safeguard Services (SGS), a Medicare program integrity contractor.

• Represented a psychiatric hospital before the Office of Medicare Hearings and Appeals in an appeal of 9 post-payment review cases where Medicare payment was denied because of alleged lack of medical necessity. The ALJ issued fully favorable decisions in all 9 cases, laying the foundation for the client to successfully challenge multiple subsequent intermediary pre-payment denials.

• Represented diagnostic and treatment center in audit of physical therapy billings by the New York Medicaid Inspector General (OMIG), succeeding in reversing a recoupment order.

• Represented skilled nursing facility in patient neglect investigation by Medicaid Fraud Unit of the New York State Attorney General's Office, resulting in no sanctions being imposed.

• Defended a multi-site physician practice group in an investigation by the New York State Office of Professional Medical Conduct, and avoided charges being brought.

• Assist skilled nursing facilities, home care agencies and physician practice groups in developing and implementing a corporate compliance program.

• Represent health care providers, including nursing homes and home care agencies, in government investigations.

• Conduct internal investigations of health care compliance matters for various types of health care providers and, where necessary, negotiate with federal and state government agencies for return of Medicare/Medicaid overpayments.

Multi-state Licensing

• Represented large institutional investor on health regulatory licensing matters in connection with acquisition of assisted living and skilled nursing facilities in 11 states.

• Served as health regulatory transaction counsel in a $230 million deal in which assisted living properties in 5 states were sold to a REIT. Advised on and coordinated all health regulatory matters in the transaction.

• Serve as health regulatory counsel to a company that owns and operates assisted living and skilled nursing facilities across the country. Handle all aspects of facility licensing in connection with acquisitions and sales in various states. Also advise on proper treatment of health regulatory matters in transaction documents, assist in due diligence, and prepare licensing opinion letters to lenders.

• Represented the investor-owner of a large national assisted living company in the acquisition of 17 assisted living facilities in 6 states. Handled all state licensure applications, obtaining license approval within the timeframe required for closing the transaction. Coordinating with the client and outside corporate counsel, we advised on health regulatory matters to ensure that transactional documents reflected regulatory requirements and prohibitions. We also prepared opinion letters to multiple lending sources, including Fannie Mae and health care REITs.

• Represent numerous owners/operators of assisted living communities on New York regulatory matters, including obtaining licenses to operate.

Miscellaneous

• Served as health regulatory counsel to a for-profit developer that obtained tax credit financing for an assisted living residence project.

• Represented the owner of an assisted living residence in a sale/leaseback transaction with a REIT.

• Arranged for Department of Health, State Attorney General and court approvals of dissolution of a non-profit nursing home corporation.

• Obtained group exemption status from the IRS for a nonprofit organization providing a variety of services to the elderly.

• Represent a skilled nursing facility in a dispute with a state Medicaid agency over the facility's level of Medicaid reimbursement.

• Succeeded in persuading CMS to withdraw a nursing home immediate jeopardy finding.

Areas of Practice

• Corporate compliance and risk management
• Compliance training
• Internal investigations
• Defense of Medicare and Medicaid audits
• Healthcare fraud and abuse
• Healthcare contracting
• Multi-state facility licensing
• Certificate of need
• Affordable housing
• Telemedicine and e-health
• Quality of care (survey) defense
• Professional rights
• Surrogate healthcare decision-making
• HIPAA and health information privacy

Admissions

• New York
• U.S. District Court for the Southern District of New York
• U.S. District Court for the Eastern District of New York
• U.S. Court of Appeals for the Second Circuit

Education

• St. John's University School of Law, New York

Experience

• Duane Morris LLP
  Of Counsel, 2022-present
  Partner, 2002-2021
• Arent Fox Kintner Plotkin & Kahn, PLLC, New York, New York
  Member, 2000 - 2002
  Associate, 1996 - 1999
• Kronish, Lieb, Weiner & Hellman LLP, New York, New York
  Associate, 1990-1996
• Spector, Scher, Feldman, Karassik & Levy, New York, New York
  Associate, 1988-1990
• U.S. Department of Health and Human Services
  Assistant Regional Counsel, 1985-1988
• American Civil Liberties Union, New York, New York
  Staff Attorney, 1983-1985

Professional Activities

• New York State Bar Association, Health Law Section
• American Health Lawyers Association
• American Seniors Housing Association, Executive Committee (Duane Morris Representative), 2001-present
• Legal Consult Editor, Long-Term Care Interface, 2001-2006
• Legal Advisory Board, Briefings on Long Term Care Compliance, 2001-2007
• Adjunct Professor of Law, Pace University School of Law, Health Law Program, 1995-1996

Honors and Awards

• Listed in The Best Lawyers in America, 2020-2024

• Listed in New York Metro Super Lawyers

Board Memberships

• Alzheimer's Association, New York City Chapter, 1997-present
  - Emeritus, 2010-present
  - Executive Committee Member, 2008-present
  - Co-chair, Board of Directors, 2004-2008

Civic and Charitable Activities

• President, Montgomery Towers Cooperative Corporation, 1991-1996
• Board of Directors, York Street Project, 1989-1997
  - Vice President, 1994-1997

Selected Publications

• "Nursing Home Visitation Will Rest on Case Count Declines, COVID Variants — Not Vaccination Rates," Skilled Nursing News, January 29, 2021
• "Why Seniors Housing Providers Need to Put Health Care Compliance on Their Radar Screen," American Seniors Housing Association Special Issue Brief, Winter 2011
• "New Developments/ALP and LHCSA Compliance Matters," Empire State Association of Assisted Living newsletter, December 2010
• "OMIG Issues Draft Regulations to Implement Statutory Requirement for Compliance Programs," Empire State Association of Assisted Living newsletter, March/April 2009
• "The Role of Home Health Care Services in Assisted Living," reprinted from the New York State Bar Association Health Law Journal in Assisted Living Consult, Vol. 5, No. 1, January/February 2009
• "Mind the Facts: Looking Beyond Inspection Reports to Evaluate Assisted Living Residences," American Seniors Housing Association Special Issue Brief, Winter 2009
• "The Role of Home Health Care Services in Assisted Living," New York State Bar Association Health Law Journal, Spring 2008, Vol. 13, No. 2
• "New York Law Requires Medicaid Providers to Establish Compliance Programs," Empire State Association of Assisted Living's newsletter, November/December 2007
• "Medicare Part D: Limitations Imposed on Residential Services Providers in Assisting Residents to Choose Their Plan," American Seniors Housing Association Legal Notes, May 2006
• "HIPAA Hits Employer Group Health Plans," Assisted Living Today, January/February 2004
• "Disability Discrimination Issues in Move-In and Retention/Discharge," American Seniors Housing Association Legal Notes, Fall 2002.
• "HIPAA Health Information Privacy Requirements: Are You Ready?," American Seniors Housing Association Legal Notes, Winter 2001-2002
• "How to Protect a Facility's Legal Rights in a Government Investigation," BNA's Health Care Fraud Report, Vol. 4, No. 2, p. 731, October 18, 2000
• "OIG Scrutinizes Nursing Home/Hospice Arrangements," Long-Term Care Compliance Advisor, Vol. 1, No. 3, August 2000
• "Avoiding Teleradiology's Legal Pitfalls," ADVANCE for Administrators in Radiology and Radiation Oncology, Vol. 10, No. 8, August 2000
• "Compliance Program Guidance Highlights New Skilled Nursing Facility Issues," Long-Term Care Interface, Vol. 1, No. 3, July/August 2000
• "Seniors Housing Corporate Compliance," American Seniors Housing Association Handbook, 1999
• "Health Care Decision-Making in New York: Living Wills," New York Law Journal, July 14, 1993 (co-authored)
• "Health Care Decision-Making in New York: Health Care Proxies," New York Law Journal, June 21, 1993 (co-authored)

Selected Speaking Engagements

• Moderator, "Accreditation of Assisted Living Panel," American Seniors Housing Association, Palm Desert, California, January 24, 2020
• "REITs and Assisted Living - Lease and Operations Issues," American Health Lawyer's Association, San Diego, CA, February 22-24, 2017
• "HIPAA and Assisted Living: Yet More HITECH Act Updates to Privacy and Security Rules," Empire State Association of Assisted Living Webinar, November 13, 2013 (co-presented with Neville Bilimoria, Duane Morris LLP)
• "Higher Acuity in Assisted Living: Risk or Reward?", Leading Age NY Annual Meeting, May 22, 2013 (co-presented with Josh Allen, Care and Compliance Group)
• "Health Care Compliance Update," a seminar co-sponsored by Navigant and Duane Morris LLP, May 1, 2013
• "A View From New York: Compliance Mandates You May See in Your State," Health Care Compliance Association Annual Compliance Institute, April 23, 2013 (co-presented with a representative of the NY Office of Medicaid Inspector General)
• Co-Moderator, Legal Issues Roundtable, Annual Meeting of American Seniors Housing Association, January 21, 2013
• "ACF/Assisted Living Legal Update," LeadingAge New York Annual Conference and Exposition, May 22, 2012
• "Health Care Compliance: What You Need to Know Now," Duane Morris Seminar, March 21, 2012
• "Admission, Discharge and the Difficult Resident," National Center for Assisted Living Spring Conference, March 13, 2012
• "Legal Responsibilities as Landlord in Seniors Housing," LeadingAge Annual Meeting, October 16, 2011
• "ACF/Assisted Living Legal Update," New York Association of Homes and Services for the Aging Annual Conference and Exposition, June 22, 2011
• "Ask the Attorneys: What You Wanted to Know, but Didn't Ask," Empire State Association of Assisted Living Annual Conference and Trade Show, May 17, 2011
• "Conducting Due Diligence," New York State Bar Association Health Law Section Webinar Series: Doing the Deal with Health Care Providers, January 11, 2011
• "Risk Management in Assisted Living," New York Association of Homes and Services for the Aging 2009 Spring Training Institute, June 1-3, 2009
• Panelist, "Managing Risk in Resident Intake," American Seniors Housing Association Operational/Legal Forum, April 24, 2009
• "Keeping Fraud and Abuse Out of Health Care Contracts," Annual Meeting of the American Association of Homes and Services for the Aging, October 14, 2008
• "Medicaid Compliance: The New Watchword for Assisted Living Programs," Empire State Association of Assisted Living Annual Meeting, May 19, 2008
• "Long Term Care Restructuring as Affecting Assisted Living Residences," New York State Bar Association 2008 Long Term Care Conference, May 2, 2008
• "Strategies for Responding to Healthcare Fraud Investigations," American Conference Institute symposium on Healthcare Fraud Investigations, March 31-April 1, 2008
• Co-Moderator, Legal Issues Roundtable, Annual Meeting of the American Seniors Housing Association, January 16, 2006
• "The Risk is Real: Healthcare Fraud Laws for Assisted Living," Annual Meeting of American Association of Home and Services for the Aging, November 9, 2005
• "Legal Issues in Caring for People with Dementia," Spring Meeting of New York State Association of Homes and Services for the Aging, June 7, 2005
• "Healthcare Fraud and Abuse Rules: They Can Apply to Assisted Living," Empire State Association of Assisted Living Annual Meeting, May 16, 2005
• "Legal Issues in Caring for People with Dementia," Empire State Association for Assisted Living Annual Meeting, May 16, 2004
• "Managing the Relationship Between You and Your Home Care Agency," Empire State Association of Assisted Living Annual Meeting, April 30, 2006
• "HIPAA for Employers," seminar sponsored by Lorman Education Services, March 30, 2004
• "Risk Management Strategies in Assisted Living Operations," Residential Care Initiatives, February 26, 2004
• "HIPAA's Effect on Small Group Health Plans," audioconference sponsored by the Assisted Living Federation of America, February 25, 2004
• Co-Moderator, Legal Issues Roundtable, Annual Meeting of the American Seniors Housing Association, January 13, 2004
• "Avoiding Legal Pitfalls: Managing Day-to-Day Operational Risks," presentation to a group of New York assisted living providers, December 8, 2003
• Presenter, "Resolving Care Issues and Effective Communication with Residents, Families and Friends," program co-sponsored by the American College of Health Care Administrators-NY and the New York State Bar Association, October 20, 2003
• "HIPAA for Health Plans," Annual Meeting of the Georgia Affiliate of the Assisted Living Federation of America, September 30, 2003
• "Avoiding Legal Pitfalls: Managing Day-to-Day Operational Risks," Empire State Association of Assisted Living Annual Meeting, May 21, 2003
• "Understanding HIPAA: The Basics for New York Assisted Living Programs," program sponsored by the Empire State Association of Assisted Living, March 6, 2003
• "Contractual Issues in Assisted Living," American Health Lawyers Association's Annual Program on Long Term Care and the Law Program, February 19-21, 2003
• "Marketing and Move-in: How to Steer Clear of Legal Pitfalls," Annual Assisted Living and Retirement Housing Summit, sponsored by the New York Association of Homes and Services for the Aging, October 17, 2002
• "Risk Management in Assisted Living Operations," Annual Meeting of American Health Care Association, October 7, 2002
• "Legal Issues in Assisted Living Operations," Spring Meeting of the New York Association of Homes and Services for the Aging, June 5, 2002
• Panelist, "Impact of Anti-Discrimination Laws on Quality of Care in Assisted Living Operations," Assisted Living Workgroup, May 16, 2002
• "Legal Issues in Caring for Alzheimer's/Dementia Residents," Spring Conference of Assisted Living Federation of America, April 4, 2002
• "Rights and Responsibilities in a Government Investigation," Long Term Care and the Law Program sponsored by Greater New York Hospital Association, December 19, 2001
• "Health Care Fraud: Why the Fuss?" Spring Conference of Assisted Living Federation of America, April 6, 2001
• "Legal Update," Spring Conference of American Association of Homes and Services for the Aging, March 13, 2001
• "Fraud and Abuse in Assisted Living: The Risk is Real," American Health Lawyers Association Annual Program on Long Term Care and the Law, February 6, 2001
• "Health Care Compliance Issues for CCRCs," CCRC Issues Forum, Annual Meeting of American Association of Homes and Services for the Aging, October 24, 2000
• "Telemedicine: A Legal Point of View," Annual Meeting of Society of Nuclear Medicine, June 6, 2000
• "Fraud and Abuse in Assisted Living: Can it Happen to You?" Annual Meeting of American Association of Homes and Services for the Aging, October 27, 1999
• "Nurse Call Centers/Telehealth Services," Telemedicine National Conference on Legal and Policy Developments sponsored by Center for Telemedicine Law and American Telemedicine Association, October 14, 1999
• "Long Term Care and Home Health," program on Fundamentals of Health Law sponsored by American Health Lawyers Association, October 6, 1998