Knicole C. Emanuel is a Partner in the Health Care practice group. For more than 18 years, Ms. Emanuel has maintained a litigation practice, concentrating on Medicare and Medicaid litigation, health care regulatory compliance, administrative law and regulatory law. She understands the intricate Medicare and Medicaid payment system, the unique business of health care providers, the overlay of federal and state Medicare and Medicaid rules and regulations, and actions of state agencies that affect the way health care entities operate.
Ms. Emanuel has tried over 1,000 administrative cases and has appeared before multiple states’ medical boards. She has successfully represented providers in matters before the North Carolina Office of Administrative Hearings and before state and federal courts in challenging or defending adverse agency decisions. She has represented national, regional and local health care providers. Those providers have included hospitals, psychiatric facilities, home health and hospice agencies, home care agencies, community mental health providers, ambulatory surgery facilities, adult care homes, nursing homes, federally qualified health care centers, and physician practices. She also served as lead counsel in a class-action lawsuit on behalf of Medicaid providers in North Carolina against NCTracks, the system that processes Medicaid claims. In September 2013, she was invited to testify before the New Mexico State Legislature’s Behavioral Health Subcommittee about the ways in which Medicaid audits have affected North Carolina providers, as well as nationwide. She is recurrently interviewed by the media as a Medicaid expert.
Ms. Emanuel frequently lectures on health care law, the impact of the Affordable Care Act (ACA) and regulatory compliance for providers, including physicians, home health and hospice, dentists, chiropractors, hospitals and durable medical equipment providers.
Ms. Emanuel served as North Carolina Assistant Attorney General in the Health and Public Assistance Section where she gained a thorough understanding of the Medicaid system that informs her practice today.
- Successfully litigated 1000+ alleged Medicaid and Medicare overpayments, some from over $12 million to as low as zero, or, in some cases, merely a couple hundred dollars.
- Successfully obtained injunctions against managed care organizations (MCO’s) when an MCO refused to contract with a health care provider.
- Successfully fought licensure penalties, including contract terminations and financial penalties, for residential groups and licensed long-term care facilities.
- Represented health care providers across the country in alleged overpayments, prepayment review, suspension of reimbursements, and terminations of contracts for both Medicare and Medicaid
- Successfully obtained federal injunction preventing a health care provider from getting terminated from the Medicaid program
- Gordon & Rees, Co-Managing Partner of Raleigh office
HONORS AND AWARDS
- Super Lawyers Magazine Rising Star (2015, 2014, 2013)
- Triangle Business Journal 50 to Watch in Business (2013)
PRO BONO AND COMMUNITY INVOLVEMENT
- Kiwanis – Board of Directors
- Brotherhood of the Warriors – Board of Directors
- Autism Services – Board of Directors
MEMBERSHIPS AND AFFILIATIONS
- American Health Lawyers Association
- North Carolina Bar Association
- Wake County Bar Association
- North Carolina Association of Women Attorneys
- Christian Legal Society
- Committee Member for North Carolina Society of Health Care Attorneys: Alert Committee and Membership & Outreach/Public Affairs
PUBLICATIONS, PRESENTATIONS AND MEDIA
- Medicaid Law-NC Blog, Author
- Medicare RAC Hot Topics and the Evolution of Regulatory Audits, Author, (May 24, 2018)
- Medicaid: The State of the Union, RACMonitor, Author, (April 19, 2018)
- Legislative Update for the North Carolina Bar, Co-author, (May 10, 2017)
- The Medlaw Update, Co-author, (October 20, 2016)
- The Yates Memo’s ‘Scary and Daunting’ Content, Author, (June 13, 2016)
In the Media
- Cardinal Innovations’ bigger-is-better pledge feels unfulfilled by advocates, providers (December 2, 2017)
- Update on the Medicare Appeals Backlog, Hospital Finance Podcast (September 6, 2017)
- Ex-CFO of Eastpointe gets 3.5 years for embezzlement (August 11, 2017)
- State lawyers want behavioral health leakers identified (February 27, 2017)
- Vermont Lawmakers Hope to Stem ACO Abuse of Tax Dollars Seen in Other States (March 31, 2017)
- Oversight Group Says Medicaid Program Detects Waste Poorly (December 7, 2016)
- Behavioral Health Care Service Still Locked in Overbilling Dispute with State (November 11, 2016)
- 10 New Mexico Nonprofits Punished Out of Existence in Kafka-esque Purge (Feb. 9, 2016)
- I-Team: Some Medicaid Providers Owe DHHS Big Bucks (June 8, 2015)
- Alamogordo center disputes state bill, hires N.C. attorney (March 14, 2014)
- Special Needs Financial Planning Seminar (November 6, 2014)
- Judge: State wrongly blocking Medicaid claims over paperwork (March 8, 2013)
- Medical providers considering lawsuits over issues with NCTracks (July 31, 2013)
- Verifying an audit’s accuracy (October 24, 2013)