Primary Industries

Bar & Court Admissions

  • State Bar of California
  • U.S. District Court for the Central District of California

Professional Affiliations

California Society for Healthcare Attorneys

Los Angeles County Bar Association (Health Care Law Section)

Education

Pepperdine University School of Law, J.D.

University of California, San Diego, B.A.

Photo of Kelly M. Hagemann

Kelly M. Hagemann

Senior Associate
Orange County
T: 714.557.7990
F: 714.557.7991
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Kelly Hagemann focuses her practice on litigation and regulatory matters in the health care industry. Kelly has successfully navigated numerous commercial disputes, counselling a diverse group of health care providers, ranging from physicians to substance abuse treatment facilities and laboratories. Likewise, she advises health care clients faced with regulatory investigations and accusations.

Having litigated and arbitrated several actions against payors who have failed to adequately reimburse out-of-network providers, Kelly has also co-chaired several trials to verdict or judgment, including cases involving breach of contract, regulatory violations, and professional negligence. In addition, she often counsels substance abuse treatment providers with regards to usual, customary and reasonable (UCR) rates, reimbursement, payor audits, medical necessity, marketing arrangements, and industry referrals. In addition, Kelly helps facility owner/operators and their laboratories with facility licensing, administrative hearings, and the development of fraud and abuse compliance programs and procedures, litigating in state and federal courts where necessary.

In terms of regulatory matters, Kelly regularly advises providers on compliance with applicable federal and state regulations, including the Affordable Care Act, Medicare, Medicaid and Medi-Cal, Knox-Keene, the Stark Act, the Anti-Kickback Act, the corporate practice of medicine, HIPAA, HITECH, and the Confidentiality of Medical Information Act. She assists with facility acquisitions, including legal due diligence and regulatory work, as well.

Pro Bono

Kelly has worked as a volunteer for California Lawyers for the Arts in Santa Monica, as well as the Public Law Center in Orange County.

Education

Kelly earned her J.D. from Pepperdine University School of Law, where she was Business and Production Editor for the Pepperdine Law Review and a Fellow for the Center for Entrepreneurship and Technology Law. She received her B.A., with a double major in Philosophy and Music Humanities from the University of California, San Diego, where she was a Regent's Scholar.

Representative Matters

Mental Health and Substance Abuse Treatment Facility Compliance: Developed policies and procedures for mental health and substance abuse providers relating to marketing, referrals and payor relationships to ensure compliance with federal and state regulations.

Substance Abuse Treatment Litigation: Represented provider in action brought by major insurer alleging illegal kickbacks in exchange for the referral of specimens to toxicology laboratory. Obtained dismissal of action.

Substance Abuse Treatment Administrative Hearing: Represented detoxification facility in administrative action brought by the California Department of Health Care Services seeking revocation of client’s license.

Arbitration: Represented a large physician group against a national laboratory corporation alleging breach of contract, fraud, and regulatory violations. The corporation was contracted to establish and manage the clients’ in-house pathology laboratory, but failed to comply with the Clinical Laboratory Improvement Amendments (CLIA), Stark Law, the False Claims Act, the anti-markup rule and California’s False Claims Act. Obtained a favorable result for client.

Special Investigations, Recoupment Requests, and Audits: Represented numerous providers in recoupment requests and audits from major payors. Settled several seven-figure demands, obtained reimbursements for clients on outstanding claims, and extracted clients from Special Investigations Unit status.

Reimbursement Dispute: Represented emergency medical transportation providers in litigation challenging Medi-Cal reimbursement rates. The Department of Health Care Services set clients’ reimbursement rates without complying with federal and state requirements, and without considering clients’ costs to provide those services. 

Independent Physician Association Reimbursement Dispute: Represented a large group of emergency physicians in litigation against an Independent Physician Association (IPA) to recover payment for services at physicians’ usual and customary rates. The IPA wrongly withheld several hundreds of thousands of dollars refusing to pay usual and customary rates for Current Procedural Terminology (CPT) codes as billed. Obtained a favorable settlement on the clients’ behalf, including payment of past amounts due, and structured agreed-upon contract rates going forward.

Professional Malpractice: Represented an attorney who was sued for malpractice, fraud, negligence and elder abuse following modifications he made to a decedent’s trust and pour-over will. The beneficiaries of testamentary documents challenged modifications and alleged a conspiracy between the client and another beneficiary.  Obtained a complete defense judgment for the client following a lengthy bench trial. The court found that the client practiced competently, the fraud and elder abuse claims were completely unfounded, and there was no conspiracy. 

Media Mentions

Past Speaking Engagements