Mary Emma has set a high standard in her profession, raised the bar for volunteer efforts, and given Solomon-wise counsel.
Sr. Margaret Ann Moser, President emeritus, Ursuline Academy


Mary Emma (Ackels) Karam is a Dallas healthcare lawyer and recognized authority in managed care law, emerging healthcare issues, and employer and corporate consulting. Her current practice consists of counseling clients on emerging healthcare implications and strategies; representing various organizations as outside general counsel and coordinator of legal work; and corporate consulting in litigation, banking, real estate, and corporate matters involving emerging healthcare issues on state and national levels.

Mary Emma has honed her approach to client service for the more than 30 years she has practiced law at Jackson Walker. She emphasizes communication, results, and an uncompromising commitment to achieving her clients’ goals, while effectively managing their legal costs. Mary Emma accomplishes this by being personally engaged in every 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 Mary Emma’s clients receive the highest level of professionalism and value in every matter she handles. She serves as outside legal counsel to numerous corporate entities. 

Healthcare/Managed Care Law

Mary Emma’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 healthcare entities and provider networks, as well as the formation of Accountable Care Organizations (ACOs), integrated delivery systems, clinically integrated networks, and various healthcare models. She currently represents seven hospitals or hospital systems and works with healthcare entities on strategic planning regarding formation of entities and integrated corporate healthcare systems to meet new managed care initiatives. She assists healthcare organizations in positioning themselves for future healthcare 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 over payment 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 healthcare, Mary Emma 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 healthcare-related contracts, plan offerings and initiatives. She also advises trusts, banking institutions, developers and other entities on strategic decisions that involve the healthcare industry.

Outside General Counsel

Mary Emma 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, Mary Emma 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, she currently serves as the general counsel to the Diocese of Dallas.

Litigation Consulting

Mary Emma 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, she never lost a jury trial. Drawing upon her strong litigation background, Mary Emma now consults in litigation matters that involve a variety of healthcare and insurance issues and advises banking and corporate institutions in disputes involving healthcare 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. She has also handled various noise matters at D/FW International Airport on behalf of an association and its member airlines.

Practice Experience

Outside General Counsel:

Coordinates legal work for companies using efficiency in staffing and advising on corporate legal strategy


Managed care law, emerging healthcare issues, and employer benefit plans

Mary Emma has represented all types of providers, healthcare organizations, and other entities in healthcare 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 benefit plans
  • Brokers

Career Highlights

  • Top 15 Business Women of Dallas, National Women’s Council, 2016
  • Pro Bono Champion, American Health Lawyers Association
  • State Bar of Texas’ Certificate of Merit
  • Distinguished Alumna Award, Ursuline Academy of Dallas
  • President’s Award, Ursuline Academy of Dallas, for her extraordinary leadership and service to support excellence in the education of young women
  • Certificate of Appreciation, Dallas Bar Association and Legal Services of North Texas, in recognition of her pro bono services, 1993
  • Texas Medical Association Philip R. Overton Lecture on Medicine and Law Plaque


  • The American Health Lawyers Association
  • Catholic Charities of Dallas, Attorneys Serving the Community
  • Children’s Medical Center of Dallas, Honorary Co-chair – Six Flags over Texas Fundraising Event, 2006
  • The Dallas Bar Association – Health Law Section
  • Dallas High Schools for the Diocese of Dallas
    • Blue Ribbon Committee
    • Saint Monica School Annual Fund Drive, Co-chair, 2009
  • The DFW Alliance for Healthcare Excellence
  • The State Bar of Texas – Health Law Section
  • Texas Bar Association, Pro Bono College, 2013-2015
  • St. Joseph’s Residence, Counsel to the Board
  • St. Jude Children’s Research Hospital, Former Host Committee Member
  • St. Philip’s School Advisory Council
    • Founder
    • Chair
  • Ursuline Academy Foundation
    • Past Chairman
    • Board of Trustees, President

News & Events

  • News & Publications
  • Speeches
  • Attorney News

    Mary Emma Karam Speaks on Business Development for Women Attorneys

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  • Spotlight

    Texas Lawyer Honors Mary Emma Karam and Amanda Zimmerman with 2017 Professional Excellence Awards

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  • Spotlight

    Mary Emma Karam Named in 2016 Top 15 Business Women of Dallas by National Women’s Council

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  • Spotlight

    Mary Emma Karam Featured in Law360’s Rainmaker Q&A Series

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  • Highlights

    New Law Continues to Require Out-of-Network Facility-Based Physicians to Notify Patients of Mediation Rights

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  • Attorney News

    Mary Emma Karam Named Pro Bono Champion for Second Consecutive Year

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  • Spotlight

    Practical, strategic leadership | Mary Emma Karam

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  • Highlights

    EEOC Proposes Rules Related to Employee Wellness Programs

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  • Highlights

    Recent Federal Court Ruling: No ERISA Preemption of Texas Prompt Pay Law Regarding Payment Deadlines; Texas Legislature May Act on Prompt Pay Issues

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  • Highlights

    Recent Federal Court Ruling on Application of Texas Prompt Pay Laws to Self-Funded, Medicaid and Out-of-State Plans and Their Third Party Administrators

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  • Attorney News

    Mary Emma Karam Named Pro Bono Champion

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  • Press Releases

    Mary Emma Karam Quoted in ‘The Texas Catholic’

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  • Press Releases

    Mary Emma Karam Participates in KPMG Executive Leadership Institute for Women

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"Top Five Changes to Make to Your Employer Health Benefit Plan to Control Costs," International Foundation of Employee Benefit Plans, September 29, 2016

"Increasing Transparency to Control Costs in Health Benefit Plan Contracts," National Health Benefits Conference & Expo, Feb 1, 2017