Denise Bloch, Counsel

Biography

Denise Bloch joined Sandberg Phoenix in 2013. With more than 20 years as a practicing attorney, Denise brings her extensive health and regulatory law experience to the firm. Most recently Denise served as Senior Director and Regulatory Counsel for a publicly traded national drug store chain and previously as Senior Corporate Counsel for a publicly traded national hospital and post-acute healthcare chain. Denise’s experience includes addressing health care issues such as privacy, compliance, reimbursement, licensure, HIPAA, Medicare/Medicaid, Stark, fraud and abuse, anti-kickback, certificate of need, Rev-Proc pharmacy and other legal health care transaction and regulatory issues. She also assists providers with survey issues, including plans of correction, Immediate Jeopardy and other Tags and appeal of imposed remedies. Denise provides direction, preparation and guidance for responding to government audits, including Medicare, Medicaid, MIC, ZPIC and others, as well as appeals of adverse findings. Denise has engaged in discussion and negotiations with governmental agencies including OCR, FTC, and other federal and state regulatory agencies concerning various compliance issues and related consent orders. In addition, Denise’s experience includes other regulatory concerns such as employment issues involving FMLA, Title VII, ADEA, ADA and wage-hour.

When working with clients, Denise uses a comprehensive approach, considering all issues and identifying the optimal outcome for her clients. She establishes goals and works to achieve them in a fair, pragmatic manner.

“I always wanted to be a lawyer,” Denise says, “whether it’s sharing my knowledge or helping my clients navigate complex issues, I love achieving my client’s goals.”

Outside of her career, Denise enjoys reading and travel as well as raising her three dogs. As a St. Louis native, Denise is happy to be back home and is enjoying all her hometown has to offer, including local restaurants and attractions.

Background

Denise earned her bachelor’s degree in Psychology from the University of Missouri – Kansas City and went on to receive her Juris Doctorate from Saint Louis University’s School of Law, graduating Cum Laude. During law school, Denise served as a legal research and writing teaching assistant and was an editor of the Saint Louis University Law Journal. She also received academic scholarships, graduated law school in the top three percent of her class and earned membership in the Order of the Wool Sack.

As a member of the Health Lawyers Association and American Bar Association, Denise stays current with legal trends and has established a strong network. She will be appointed Vice-Chair of the Missouri Bar’s Health and Hospital Administration Law Committee for the 2016-2017 bar year.

Denise served on the St. Louis chapter board of the American Diabetes Association, and ran the Maui Marathon as a member of Team Diabetes. She also served on the Benefits and Insurance Commission for the City of Town and Country and the Allocations Committee for Variety, the Children’s Charity of St. Louis.

Denise is licensed to practice law in Missouri, Illinois and Pennsylvania, and before the U.S. District Court, Southern District of Illinois and U.S. Court of Appeals, Seventh and Eighth Circuits.

Client Successes

Led in-house compliance task force and successfully implemented necessary changes to company policy and procedures to comply with HIPAA/HITECH Final Rule. Represented company in negotiations and discussion with various governmental agencies including OCR, FTC, and other federal and state regulatory agencies.

Established and managed Medicare appeals department handling denied provider reimbursement claims of $17,000,000 per year with an average overturn rate of 80% resulting in return of over $13,000,000 to company and its clients each year.

Defeated Motion for Summary Determination brought by the Missouri Bureau of Healing Arts seeking disciplinary action against physician under Section 339.100.2(23). As a result of the Administrative Hearing Commission ruling, physician received a reprimand rather than being placed under an order of probation, suspension, or revocation.

Reported Cases

  • Teets v. American Family Mut. Ins. Co., 272 S.W.3d 455, 2008 WL 5423987, Mo.App. E.D., December 9, 2008.
  • Teets v. American Family Mut. Ins. Co., Not reported in F. Supp.2d, 2005 WL 5784770, E.D. Mo., January 14, 2005 (No. 4:04CV902SNL).
  • Page v. Clark Refining & Marketing, Inc. 996 S.W.2d 678, 1999 WL 308768, Mo.App. E.D., May 18, 1999.
  • Bell v. Dobbs Intern. Service, 6 F. Supp. 2d 863, 1998 WL 262449, 84 Fair Empl. Prac. Cas. (BNA) 542, E.D. Mo., May 20, 1998.
  • State ex rel. Hammock v. Dowd, 938 S.W.2d 675, 1997 WL 63599, Mo.App. E.D., February 18, 1997.
  • L.B.E., Inc. v. LaClear, 889 S.W.2d 179, 1994 WL 705371, Mo.App. E.D., December 20, 1994.

Speaking Engagements

  • HIPAA/HITECH: Protecting Patient Privacy and Next Steps: Be Ready for HIPAA Audits, MLN Institute for Nursing Home Administrators, March 6, 2015, Lake of the Ozarks, MO
  • The ABC’s of the Affordable Health Care Act and Healthcare Reform – IL Chamber of Commerce, February 4, 2015, Belleville, IL
  • HIPAA/HITECH – Protecting Patient Privacy, MO League for Nursing – Nursing Home Administrator Oktoberfest, October 16, 2014, Branson, MO
  • Medical Records Law in IL – Recordkeeping and Retention Guidelines and Association Guidelines for Document Management: Lorman Education Services, July 10, 2014, O’Fallon, IL
  • HIPAA/HITECH:  Protecting Patient Privacy:  Missouri Association of Nursing Home Administrators (MANHA) Spring Conference, June 1, 2014, Lake of the Ozarks, Missouri
  • Affordable Care Act, What it may mean to you:  St. Louis Paralegal Association, 38th Annual Paralegal Day, May 9, 2014, St. Louis, Missouri
  • HIPAA/HITECH:  Protecting Patient Privacy:  Missouri Assisted Living Association (MALA) Spring Conference, April 14, 2014, Excelsior Springs, Missouri
  • How to Handle Identity Theft – It is not a Matter of “If” but “When”:  Site Improvement Association, 29th Management Seminar, January 24, 2014, Puerto Vallarta, Mexico
  • Internal Auditing:  Medical Group Management Association (MGMA) St. Louis Practice Advocacy Conference, October 16, 2013, St. Charles, Missouri
  • Affordable Care Act Update: Site Improvement Association – October meeting, October 9, 2013, St. Louis, Missouri
  • HIPAA and HITECH Refresher and Update: Missouri Assisted Living Association  (MALA) 2013 Fall Conference, October 6, 2013, Lake of the Ozarks, Missouri
  • International Pharmaceutical Privacy Consortium Workshop – HIPAA/HITECH
    Compliance: Sales and Marketing Requirements and Best Practices: Panel on
    Subsidized Patient Communication Programs, June 5, 2013, Washington, D.C.
  • Acute Long Term Hospital Association-Legal Issues Meeting: Medical Necessity
    Reviews from the Legal Perspective, September 29, 2010, Baltimore, Maryland.
  • Health Care Compliance Association-Midwest Regional Annual Conference: RAC
    Panel Discussion, September 24, 2010, Kansas City, Missouri.
  • American Health Lawyers Association-Institute on Medicare and Medicaid Payment
    Issues: Preparing for RAC and MIC Audits: In-House and Outside Counsel
    Perspectives, March 24-26, 2010, Baltimore, Maryland.
  • American Case Management Association-Hospital Case Management Practice Based
    Education: Getting Ready for the RACs, 9/22/09, St. Louis, Missouri.
  • National Medicare RAC Summit-Forum on the Medicare Recovery Audit Contractor
    (RAC) Program: Update on National RAC Implementation-the View from the
    Provider Constituencies, 9/14/09-9/15/09, Washington, DC.
  • Lorman: HIPAA Privacy Regulations and Workers’ Compensation in Missouri –
    12/9/03, St. Louis, Missouri.
  • Sterling Education Services: Fundamentals of Employment Law–Sex, Race, and Other
    Harassment in the Workplace, 12/03/03, St. Louis, Missouri.
  • Council on Education in Management-Missouri Best Practice in FMLA Administration:
    Deciphering Your Employer and Employee Notification Requirements Under the
    FMLA, 5/29/03, St. Louis, Missouri.
  • Lorman: Employee Discharge and Documentation in Illinois–Avoiding Employment
    Litigation, 2/19/03, Collinsville, Illinois.

Publications

BIOGRAPHY

Denise Bloch joined Sandberg Phoenix in 2013. With more than 20 years as a practicing attorney, Denise brings her extensive health and regulatory law experience to the firm. Most recently Denise served as Senior Director and Regulatory Counsel for a publically traded national drug store chain and previously as Senior Corporate Counsel for a publically traded national hospital and post-acute healthcare chain. Denise’s experience includes addressing health care issues such as privacy, compliance, reimbursement, licensure, HIPAA, Medicare/Medicaid, Stark, fraud and abuse, anti-kickback, certificate of need, Rev-Proc pharmacy and other legal health care transactional and regulatory issues. She also assists providers with survey issues, including plans of correction, Immediate Jeopardy and other Tags and appeal of imposed remedies. Denise provides direction, preparation and guidance for responding to government audits, including Medicare, Medicaid, MIC, 2PIC and others, as well as appeals of adverse findings. In addition, Denise’s experience includes other regulatory concerns such as employment issues involving FMLA, Title VII, ADEA, ADA and wage-hour.

When working with clients, Denise uses a comprehensive approach, considering all issues and identifying the optimal outcome for her clients. She establishes goals and works to achieve them in a fair, pragmatic manner.

“I always wanted to be a lawyer,” Denise says, “whether it’s sharing my knowledge or helping my clients navigate complex issues, I love achieving my client’s goals.”

Outside of her career, Denise enjoys reading and travel as well as raising her three dogs. As a St. Louis native, Denise is happy to be back home and is enjoying all her hometown has to offer, including local restaurants and attractions.

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The information on this website is for general information purposes only. Nothing on this site should be taken as legal advice for any individual case or situation. This information is not intended to create, and receipt or viewing does not constitute, an attorney-client relationship. © 2016 Sandberg Phoenix & von Gontard P.C. All Rights Reserved. Sandberg Phoenix & Von Gontard P.C.is a law firm with a primary office located in Downtown St. Louis, Missouri. Website Hosted by St. Louis Web Hosting

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