Advising behavioral health provider group on compliance with HIPAA and federal regulations on disclosure of substance use disorder records; drafted new notice of privacy practices and new HIPAA release authorizations.

Represented client group practice in recovering two years of underpayments on behavioral health claims from Anthem, health insurance carrier.

Successfully advised regional hospital system on Medicaid MCO regulatory matter heard at CHFS Div. of Administrative Hearings Branch.

Successfully represented regional hospital system in Medicaid administrative hearing and appeal at CHFS Div. of Administrative Hearings Branch against Medicaid MCO on behavioral health inpatient claim.

Advised Substance Use Disorder rehabilitation clinic on CMS and HIPAA compliance for contractual relationship with independent billing company and drafted agreement for billing services.

Reviewed and advised contracts between client hospital corporation and various insurers and health care systems in multiple states, and advised client hospital corporation on types of Medicare Accountable Care Organization payment models and related ACO participant agreements.

Represented health insurer/services provider in DOL audit and investigation of group health plan for compliance with ERISA provisions of the Affordable Care Act and the Mental Health Parity and Addiction Equity Act pertaining to parity in the provision of mental health benefits for substance use disorder treatment.

Researched and drafted federal Medicare Part C compliance contracts for hospital and health care providers; contracts for federal Medicare Part C compliance with Medicare Advantage agents, marketing entities, vendors and other downstream contractors on behalf of Medicare Advantage plan client; drafted for federal Medicare Part D compliance and negotiated terms of Pharmacy Benefits Management agreement with national PBM on behalf of Medicare Advantage plan, and negotiated Medicare Advantage provider agreements with hospital and medical group providers.

Reviewed, revised and negotiated terms of health plan agreement with pharmacy benefits consultant.

Best Lawyers in America®: Health Care Law

Fayette County Bar Association Citizen Lawyer Award (2021)

American Health Lawyers Association, Managed Care Section

Fayette County Bar Association, Health Care Section

Kentucky Bar Association, Heath Care, Business Law and Bankruptcy Sections

Kentucky Chamber of Commerce Health Care Policy Council

“Surprise! What the “No Surprises Act” Means for Patients, Providers and Health Plans,” Medical News (May 2021)

“New HIPAA Privacy Rule Revisions–What You Need to Know,” (with Emily Pence) M.D. Update (April 2021)

“As Overdose Deaths Rise, Kentucky Proposes First in Nation Plan to Expand Medicaid Coverage for Inmates,” Medical News (Jan. 2021)

“Revised SUD Confidentiality Rules—What’s Changed and What Hasn’t,” M.D. Update (Dec. 2020)

“Significant Amendments to Kentucky’s Health Insurance Utilization Review Laws,” M.D. Update (Nov. 2019)

“Unanswered Questions Left in the Wake of the Medical Review Panel Act’s Demise,” M.D. Update (March 2019)

“New Kentucky Legislation Clears State Law Barriers to Direct Primary Care Practice Model,” M.D. Update (Nov. 2017)

“Fair Market Value in Physician Compensation Arrangements under the Stark Law,” M.D. Update (Jan. 2016)

“Treating Patients by Telehealth in Kentucky,” M.D. Update (Nov. 2014)

How to Manage a Compliant Health Benefit Plan: DOL Audits & Fiduciary Responsibility (February 2018)

University of Louisville, J.D.

University of Kentucky, B.A.

Sarah Charles is dedicated to helping women in difficult situations get a fresh start in life. She is a founding Director and now serves as a member of the Advisory Board and the Program Committee for The Well of Lexington. She works directly with women in The Well’s residential recovery program who have survived sexual and other severe trauma and substance abuse.