Celebrating 125 Years

Mary Emma  Karam


Mary Emma (Ackels) Karam has practiced law at Jackson Walker for more than 30 years, providing practical advice and strategic thinking to clients in a wide range of legal matters. Her current practice consists of counseling clients on health care implications and strategies; representing various organizations as outside general counsel and coordinator of legal work; and consulting in litigation, banking, real estate, and corporate matters involving emerging health care issues in the marketplace.

Ms. Karam's dedication to client service differentiates her practice. She emphasizes communication, results, and an uncompromising commitment to achieving her clients' goals while effectively managing their legal costs. Ms. Karam accomplishes this by being personally engaged in every legal decision that affects her clients, from selecting a legal team, to overseeing strategy, to reviewing every bill. Her deep level of involvement and attention to detail ensures that Ms. Karam's clients receive the highest level of professionalism and value in every matter she handles.

Ms. Karam has developed particular experience in the following areas:

Health Care/Managed Care Law
Ms. Karam is recognized as an authority in the field of health care/managed care law and was appointed by the Texas Attorney General to serve a term as Special Outside Counsel to the Office of the Attorney General for the State of Texas for consultation in health care/managed care matters for the state (2000 - 2001). For the past 25 years, Ms. Karam has reviewed and negotiated all forms of managed care contracts including PPO, HMO, indemnity, traditional, managed Medicare and Medicaid Advantage, STAR and STAR+Plus programs, and workers compensation. She consults on national contracts, including revisions of a plan’s managed care contract form for a national hospital system to use in 47 states.

Ms. Karam's wide range of experience gives her a unique ability to advise on the multiple aspects of the contracting process, including issues related to the employer, member, plan, managed care organizations, third-party administrator, broker, and regulatory oversight. Her diverse background also enables her to provide invaluable assistance in the sale or transfer of health care entities and provider networks, as well as the formation of Accountable Care Organizations (ACOs), integrated delivery systems, clinically integrated networks, and various health care models.

Ms. Karam currently represents seven hospitals or hospital systems. She works with health care entities on strategic planning regarding formation of entities and integrated corporate health care systems to meet new managed care initiatives. She assists health care organizations in positioning themselves for future health care ventures. She counsels clients on medical staff issues, credentialing matters, contract review, management service agreements, employment agreements, recruitment and shareholder agreements, practice acquisitions, auditing and overpayment issues, prompt payment, clean claims, and medical records.

Employer and Corporate Consulting
With a broad background in health insurance contracting and practical experience in the business of health care, Ms. Karam represents employers and works with human resource departments in the analysis of the various components of their health insurance benefit plans, third-party administrator agreements and brokerage arrangements. She advises Employer Benefit Plans on health care-related contracts, plan offerings and initiatives. She also advises trusts, banking institutions, developers and other entities on strategic decisions that involve the health care industry.

Outside General Counsel
Ms. Karam acts as outside general counsel and advisor to several client entities, selecting legal teams and overseeing work for clients who have needs in several legal areas. In this facet of her practice, Ms. Karam demonstrates her commitment to client service by taking the time to gain a thorough understanding of her clients' business, providing value-added solutions, and personally ensuring that the clients' legal needs are met in an efficient and cost-effective manner. As part of this practice, Ms. Karam currently serves as the general counsel to the Diocese of Dallas.

Litigation Consulting
Ms. Karam began her career in litigation and quickly distinguished herself as a skilled trial lawyer. In 12 years as a litigator, trying at least one case every year, Ms. Karam never lost a jury trial. Drawing upon her strong litigation background, Ms. Karam now consults in litigation matters that involve a variety of health care and insurance issues and advises banking and corporate institutions in disputes involving health care matters. She has tried numerous jury and bench trials, representing a variety of corporate clients in various business litigation matters. For several years, she represented Texas Utilities in nuclear power plant litigation, involving the coordination of a large number of attorneys, engineers, and other professionals; the briefing and argument of numerous legal issues; and the organization, review, production and maintenance of more than 40 million pages of documents. Ms. Karam has also handled various noise matters at D/FW International Airport on behalf of an association and its member airlines.

Representative Clients
Ms. Karam represents all types of providers, health care organizations, and other entities in health care matters including:

  • Hospitals
  • Academic medical centers
  • Laboratories
  • Acute care centers
  • Independent practice associations (IPAs)
  • Preferred provider organizations (PPOs)
  • Managed care organizations
  • Physician-owned hospitals
  • Ancillary service centers
  • Physicians
  • Dentists
  • Durable medical equipment suppliers
  • Nursing homes
  • Assisted living facilities
  • Management companies
  • Employer's health care plans
  • Brokers

More about Mary Emma Karam: Involvement | Recognition | Speeches / Publications | News

Organization Membership

Ms. Karam is a member of the American Health Lawyers Association, the State Bar of Texas and its Health Law Section, and the Dallas Bar Association and its Health Law Section and the DFW Alliance for Healthcare Excellence.

Community Involvement

Ms. Karam is deeply committed to giving back to the community through civic activities and pro bono work. She is a member of Attorneys Serving the Community and has played a leadership role in a number of charitable organizations. Most recently, Ms. Karam founded and chaired the St. Philip's School Advisory Council, which works to provide much-needed resources to support the school and its students. For years, she has served on the host committee for St. Jude Children's Research Hospital's annual Dallas event. With her husband, Albert G. Karam, M.D., she served as honorary Co-Chair of Children's Medical Center of Dallas annual fundraising event at Six Flags over Texas in 2006. She received the Distinguished Alumna Award from Ursuline Academy of Dallas, where she is Past-Chairman of the Ursuline Academy Foundation and Past-President of its Board of Trustees. In 2007, she received the President's Award for her extraordinary leadership and service to support excellence in the education of young women. She was also appointed to serve on the Blue Ribbon Committee for Dallas High Schools for the Diocese of Dallas. She also Co-Chaired the 2009 Saint Monica School Annual Fund Drive.

For many years, Ms. Karam has dedicated more than 200 hours per year to pro bono work and is a member of the Texas Bar Association Pro Bono College for 2013, 2014, and 2015. She serves as counsel to the Board of St. Joseph's Residence, a non-profit assisted living facility for the indigent and underserved, and provides volunteer legal services for Catholic Charities of Dallas and other Diocesan outreach programs. In recognition of her pro bono services, the American Health Lawyers Association (AHLA) named her a Pro Bono Champion in 2014 and 2015 and the Dallas Bar Association and Legal Services of North Texas awarded her a Certificate of Appreciation in 1993.

More about Mary Emma Karam: Biography | Recognition | Speeches / Publications | News

Peer Recognition

Ms. Karam is a recipient of the State Bar of Texas' Certificate of Merit for having rendered outstanding service to the legal profession. She also received the distinguished Alumna Award from Ursuline Academy of Dallas, as well as the President's Award for her extraordinary leadership and service to support excellence in the education of young women. In recognition of her pro bono services, the Dallas Bar Association and Legal Services of North Texas awarded her a Certificate of Appreciation in 1993. Ms. Karam was named a Pro Bono Champion in 2014 by the American Health Lawyers Association (AHLA).

More about Mary Emma Karam: Biography | Involvement | Speeches / Publications | News

Speeches / Publications

Ms. Karam has given numerous presentations at health care forums, medical societies, health leadership councils, board meetings, and shareholder meetings of health care corporations. She was awarded the Texas Medical Association Philip R. Overton Lecture on Medicine and Law plaque, commemorating her presentation on managed care contracting to the TMA Leadership Conference.

Ms. Karam is the author of many articles published on health care matters, managed care contracting, and prompt payment issues in state and national publications as well as securities and labor law articles published in the Southwestern Law Journal.

Ms. Karam is a frequent speaker on managed care contracting and health care topics. A few representative examples of her speaking engagements include the following:

  • "Health Plan Checkup: Maintaining a Healthy Relationship with your Broker, Insurer, and Third Party Administrator," 2015 Labor and Employment Seminar, Westin Hotel, Dallas, Texas, November 2015
  • "What You Should Know About Your Health Benefit Plan and Pharmacy Program," Health Care Law Seminar: What Keeps You Up at Night, Dallas Country Club, September 2015
  • "Top Five Changes to Make Your Employer Benefit Plan Contracts," Member Benefit Plan Roundtable Presentations, Dallas, Texas, 2015
  • "Enhancing the Revenue Cycle: Admission to Audit," Teaching Hospitals of Texas, October 2014
  • "Update on Affordable Care Organizations: Positioning Your Hospital for the Future of Healthcare," Teaching Hospitals of Texas, October 2014
  • "Building Business Relationships and Work/Life Balance," GameStop Women’s Leadership Conference, September 2014
  • "Secrets of Managed Care and Questions about Accountable Care Organizations," Teaching Hospitals of Texas, October 2013
  • "Managed Care Contracting," National Medical Group Management Association Annual Conference, Las Vegas, Nevada, Fall 2011
  • "Accountable Care Organizations (ACOs): Blueprint for Success," North Texas American College of Healthcare Executives, panel presentation, May 2011
  • "Understanding Key Legal Provisions and Impact of ERISA," 2010 Fall Managed Care Forum for the National Association of Managed Care Physicians, Winter 2010

Links to Publications

More about Mary Emma Karam: Biography | Involvement | Recognition | News

  • Mary Emma Karam
Dallas Office
T: 214.953.6041
F: 214.661.6652

Practice Areas

B.A., summa cum laude, Spring Hill College (AL)
  • Graduated first in her class

J.D., Southern Methodist University Dedman School of Law
  • Order of the Coif (Top 10%)
  • Editor, Southwestern Law Journal
  • The Outstanding Oral Advocate in the law school Moot Court competition
  • Best Brief Award recipient in the National Moot Court Competition
  • National Order of Barristers
Bar Admissions

  • 1979, Texas
Court Admissions

  • United States Supreme Court
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