Jennifer Evans brings legal, legislative and operational experience to health care matters. Her legal practice is focused on fraud and abuse, Medicare and Medicaid reimbursement issues, and regulatory compliance. She represents a variety of client types including:
  • Large and small hospital systems
  • Children's hospitals
  • Multi-state specialty service providers (e.g. dentistry, dialysis, diagnostic testing, pharmacy)
  • Durable medical equipment Suppliers
  • Health care manufacturers
  • Physician practice managers
  • Laboratories
  • Health care management franchisors
  • Specialty services extensions of physician practices

Jennifer served as deputy director of the Colorado Department of Health Care Policy and Financing, the single state agency responsible for administering Medicaid and the Child Health Plan Plus programs. At HCPF, she served as office director for administration and operations with responsibility for audit, procurement, program integrity, coordination of benefits, privacy, provider enrollment, claims payment, operations, and information technology, including health information technology.

In addition to her role at the HCPF, Jennifer served on the National Governors' Association Center for Best Practices working group on Health Information Technology and Exchange, and has experience representing nonprofit and for profit health care organizations before Congress and CMS. She also is a former legislative assistant for health care and legislative director in the U.S. Senate, and was a working group member of the Clinton White House Task Force on Health Care Reform.
  • Secured favorable Advisory Opinion from the HHS/OIG opining that an arrangement would not create prohibited remuneration under the anti-kickback statute, and would not subject a client to administrative sanctions or exclusion from participation in Medicare and Medicaid
  • Advising clients on federal health care program reimbursement and payment issues, including Medicare and Medicaid requirements and limitations
  • Resolution of Medicaid overpayment investigations without imposition of penalties
  • Advised hospital associations regarding development and implementation of supplemental payment program through inter-governmental transfer and use of provider fees in the Medicaid program
  • Advising clients on fraud and abuse issues and implications of corporate transactions in a variety of forms including joint ventures with physician and hospital referrals, appropriate billing and cost reporting to Medicare and Medicaid, payments to physicians other than referral sources, and overpayment returns to Medicare and Medicaid
  • Resolution of Medicaid and Medicare reimbursement issues
  • Defending clients against allegations of fraud and abuse and submission of false claims.
  • Settlement of overpayment allegations by commercial health insurers
  • Building and maintaining a compliance program for health care provider to avoid prospective violations of fraud and abuse laws and avoid the submission of false claims
  • Advising clients regarding Medicare DME competitive bid awards
  • Participating in the negotiation and implementation of corporate integrity agreements and final settlement of health care fraud and abuse investigations
  • Operational responsibility for Medicaid claims payment totaling nearly $4 billion per year
  • Negotiating $50 million multi-year information technology contract for eligibility determination
  • Management of external audit and program integrity contractors