Jesse counsels health care providers on federal and state anti-kickback laws, the Stark physician self-referral law, Medicare and Medicaid reimbursement, enrollment and participation issues, HIPAA and state privacy and confidentiality matters, as well as federal and state antitrust issues. Jesse provides legal guidance to a variety of different types of health care providers, including public and private hospitals, physician groups of various sizes and specialties, and ancillary service providers, such as imaging facilities and ambulatory surgery centers.
Prior to joining Gray Plant Mooty, Jesse served as assistant attorney general in the Health Care and Antitrust Division of the Minnesota Attorney General's Office. During that time, he focused on regulatory matters, including enforcement of various laws that govern the operation of health care organizations in Minnesota, as well as providing legal advice to various state agencies, such as the Minnesota Department of Health.
Jesse is an FAA-licensed private pilot and a former spinning instructor. He resides in St. Paul.
Experience
- Structuring joint ventures and other collaborations among health care providers to comply with federal and state regulatory laws, including Stark Law and Anti-Kickback Statute
- Assisting providers and suppliers of various sizes and types in complying with Medicare and Medicaid rules and regulations, including provider-based regulations, independent diagnostic testing facility requirements, durable medical equipment supplier regulations, anti-markup rules, CLIA requirements and billing, coding and payment standards.
- Representation in response to qui tam cases filed for alleged violations of False Claims Act
- Assisting providers in responding to regulatory inquiries and investigations, including matters involving alleged fraud and abuse and Stark Law violations, CLIA proficiency testing, HIPAA violations, Medicare/Medicaid enrollment matters and issues involving overpayments and self-disclosure
- Representation of multi-specialty physician group in securing Advisory Opinion 10-15 from U.S. Department of Health and Human Services Office of Inspector General
Publications
- “Shutdowns, Cuts and Stalemates: the Story of Health Care in the 2011 Legislative Session,” Minnesota Health Care News, December 2011
- “Program Integrity—Keeping the Bad Guys Out, but Making Things Harder for the Good Guys,” Minnesota Physician, November 2011
- “Anti-Kickback and the ‘One Purpose Test,’” Journal of the Association of State Physician Recruiters, Volume 18, Issue 4, Fall 2011
- “CMS Announces New Medicare Enrollment Revalidation Initiative, Issues Revised Enrollment Applications," Gray Plant Mooty Health Law Alert, August 29, 2011
- "HHS Releases Proposed Regulations Dramatically Expanding HIPAA Accounting of Disclosures Requirements," Gray Plant Mooty Health Law Alert, June 16, 2011
- "OIG Audit Exposes Vulnerabilities in HIPAA Security Rule Compliance, Offers Lessons for Covered Entities and Business Associates," Gray Plant Mooty Health Law Alert, June 2, 2011
- “Attestation and Third-Party Registration Now Available for Medicare Electronic Health Records Incentive Programs,” Gray Plant Mooty Health Law Alert, May 3, 2011
- “CMS Issues Proposed ACO Regulations,” Gray Plant Mooty Health Law Alert, April 13, 2011
- “The Brave New World of Health Care Fraud and Abuse: New Civil Fraud Unit Reflects National Trends,” coauthor, GPM In-House Litigator, Spring 2011
- "Health Care Meets a New Dynamic: Can Republican Legislature, DFL Governor Find Compromise?" Minnesota Health Care News, January 2011
- “Politics, Money Dominate Health Care Debate: 2010 Minnesota Legislature Focuses on Making Do,” Minnesota Health Care News, September 2010
- “Medicare Fraud and Abuse: Health Care Reform Raises the Stakes,” coauthor, Minnesota Physician, June 2010
- “Adrift on a Sea of Red Ink: Minnesota Legislature Faces Huge Financial Pressure,” Minnesota Health Care News, February 2010
- “Legislation: No Easy Answers,” Minnesota Health Care News, September 2009
- “A State False Claims Act? Just When You Thought You Had Enough to Worry About,” Minnesota Physician, May 2009
- “In the Red: Huge Budget Deficit Will Slow Health Care,” Minnesota Health Care News, coauthor with Catherine Bitzan, January 2009
- “U.S. Senate candidates on health care: Sen. Norm Coleman and his DFL challenger Al Franken address a critical issue,” Minnesota Health Care News, September 2008
- “Health Care in the 2008 Legislature: Moving Forward Incrementally,” Minnesota Health Care News, August 2008
- “A Day Late; A Dollar Short: 2008 Legislative Session Fails to Meet Goals,” Minnesota Health Care News, August 2008
- “Healthcare in the 2008 Legislature: Stalking an Elusive Goal,” Minnesota Health Care News, February 2008
- “Summary of South Dakota's Fraud and Abuse Statutes & Regulations,” American Health Lawyers Association's Fifty State Survey of Fraud & Abuse Statutes and Regulations, September 2007
- “2007 Legislature Achieves Precious Little in Health Care; Reform Proponents Expect Better Results in 2008,” Minnesota Health Care News, August 2007
- “Consumer Fraud & Deceptive Trade Practice Regulation in Minnesota,” Minnesota Continuing Legal Education Deskbook, contributing author, 2007
- “Will the New Balance of Power Set a New Tone in Health Care?,” Minnesota Health Care News, February 2007
- “Minnesota Mental Health and the Law 2007: Confidentiality and Release of Mental Health Information,” Health Ed, February 16, 2007
- “Everyday Antitrust Issues,” Minnesota Physician, coauthored with Tim Johnson, November 2006
- “HIPAA's Assault on the Ivory Tower: the Privacy Law Lays Siege to the College Campus,” Health Law Wisconsin, Fall 2002
- “A Phony War No More: DOJ Efforts to Enforce Stark Through the False Claims Act,” Health Law Wisconsin, Summer 2002
Presentations
- “Future of Health Care Enforcement and Accountability,” Nebraska Hospital Association Annual Convention, October 20, 2011
- “The Final Accountable Care Organization Regulations: One Part Flexibility, Two Parts Complexity,” copresenter, Gray Plant Mooty Health Law Roundtable Breakfast Program, November 30, 2011
- “The New Accountable Care Organization Regulations: A Mystery Only Partially Revealed,” copresenter, Gray Plant Mooty Health Law Practice Group Breakfast Roundtable, May 4, 2011
- "Death Panels, Tanning Beds and AK-47s: What You Need to Know About Healthcare Reform," Minnesota Radiological Society 2011 Spring Meeting, April 9, 2011
- "Between a Rock and a Hard Place: Next Steps When You Fear a Stark or Kickback Violation Has Occurred in Your Shop," copresenter, Gray Plant Mooty Health Law Practice Group Breakfast Roundtable, February 22, 2011
- "A Target on Your Back: The New Reality of the False Claims Act," copresenter, Aging Services of Minnesota 2011 Institute, February 9-11, 2011
- “Audacious Goals and Grand Plans: Obtaining an OIG Advisory Opinion for a $200 Million Joint Venture,” copresenter, Legal Issues Affecting Academic Medical Centers and Other Teaching Institutions, American Health Lawyers Association, Washington, DC, January 27-28, 2011
- “The Meaning of ‘Meaningful Use’ and Proposed Changes to HIPAA Privacy, Security, and Enforcement Rules,” copresenter, Gray Plant Mooty Health Law Practice Group Breakfast Roundtable, October 12, 2010
- "A Target on Your Back: The New Reality of the False Claims Act," copresenter, Aging Services Annual Meeting and Leadership Forum, Brainerd, Minnesota, February 22, 2011; Minneapolis, Minnesota, September 23, 2010
- "Under the Radar No Longer: Anti-Fraud Efforts Target Smaller Providers," Minnesota Medical Group Management Association 2010 Summer Conference, August 6, 2010
- "No Longer Under the Radar: Increased Fraud Enforcement Affects All Providers," copresenter, Gray Plant Mooty 14th Annual Health Law Conference, July 15, 2010
- "Health Care Reform: Discovering Opportunities and Dispelling Myths," copresenter, Gray Plant Mooty 14th Annual Health Law Conference, July 15, 2010
- “Have Your Hospital Governance Documents Kept Pace with the Latest Requirements,” Minnesota Hospital Association's 24th Annual Summer Trustee Conference, copresenter, July 10, 2010
- “The Future of Health Care Enforcement and Accountability,” Minnesota Hospital Association's 24th Annual Summer Trustee Conference, copresenter, July 10, 2010
- “Caught in the Crosshairs: Strategies for Responding When Health Regulators Come Calling,” copresenter, The 2010 Health Law Institute, Minneapolis, Minnesota, June 11, 2010
- “Death Panels, Tanning Beds, and AK47s: What Providers Need to Know About Health Care Reform,” panelist, Gray Plant Mooty Health Law Practice Group Breakfast Roundtable, May 26, 2010
- “A HITECH Prescription for HIPAA Compliance: What the New Privacy and Security Requirements Mean for You,” copresenter, Gray Plant Mooty Health Law Practice Group Breakfast Roundtable, November 5, 2009
- “A HITECH Prescription for HIPAA,” Triium Group Purchasing Conference, October 30, 2009
- “The HITECH Act: Carrots, Sticks...and Teeth,” Gray Plant Mooty 13th Annual Health Law Conference, July 16, 2009
- “Medical Records Law in Minnesota,” Lorman Education Service Conference, St. Cloud, Minnesota, July 7, 2009
- “Medical Records Law in Minnesota,” Lorman Education Service Conference, Bloomington, Minnesota, June 4, 2009
- “Minnesota Mental Health and the Law 2009,” Health Ed Seminar, copresenter, March 6, 2009
- “The Stark Law is Finally Final: An overview of the new rules and a discussion of the top 10 provider risk areas for 2009,“ copresenter, Gray Plant Mooty Health Law Team 2008 Roundtable Discussions, November 6, 2008
- “Can I Buy You a Drink? Legal Issues in the Physician Vendor Relationship,” Medical Group Management Association’s 2008 Annual Conference, San Diego, California, October 21, 2008
- “HIPAA Fundamentals,” American Bar Association’s Health Law Fundamentals Teleconference Series, copresenter, September 25, 2008
- “Benefits and Burdens of Affiliations, Collaborations or Partnerships,” Minnesota Hospital Association’s 22nd Annual Trustee Conference, copresented, July 12, 2008
- “Nurturing the Hospital-Physician Relationship,” Minnesota Hospital Association’s 22nd Annual Trustee Conference, copresented, July 12, 2008
- “Medical Records Law in Minnesota,” (Lorman), Minneapolis, Minnesota, June 4, 2008-2009; St. Cloud, Minnesota, July 1, 2008; Rochester, Minnesota, July 23, 2008
- “More Heat Than Light: Proposals, Retractions, Delays - and a Few Enactments,” copresenter, Gray Plant Mooty 12th Annual Health Law Conference, July 17, 2008
- “The Vendor Relationship: Can I Buy You a Drink?,“ copresenter, Gray Plant Mooty Health Law Team 2008 Roundtable Discussions, May 22, 2008
- “Confidentiality and Release of Mental Health Information,” HealthEd Minnesota Mental Health and the Law 2008 seminar, March 7, 2008
- “Can I Buy You a Drink: Challenges Posed by the Physician-Provider Relationship,” Minnesota Medical Group Management Association’s 2008 Winter Conference, copresented, March 5, 2008
- “The Good, the Bad, & the Ugly: A Legislative Update,“ Gray Plant Mooty 11th Annual Health Law Conference, July 19,2007
- “Monopoly is not just a Board Game: Everyday Antitrust Issues in Educational Procurement,” National Association of Educational Procurement, copresented, March 2007
- “Health Information Securities Strategies,” (Lorman) Health Information Management in Minnesota, March 30, 2007
- “Compliance Plans—What they are and why you should have one,” Minnesota Association of Mental Health Residential Facilities, October 11, 2006
- “Stop It! What Naughty Activities Are Catching The Attention Of State And Federal Regulators?,“ copresenter, Gray Plant Mooty 10th Annual Health Law Conference, July 20, 2006
Education
- Saint Louis University School of Law, J.D., cum laude
- Saint Louis University School of Law, Certificate in Health Law
- Saint Louis University School of Public Health, M.P.H.
- University of Minnesota, B.A.
Bar Admissions
Professional Activities
- American Health Lawyers Association, 2001-present
Honors and Distinctions
- "Rising Star," Minnesota Law & Politics, 2010