Medicare/Medicaid/
Reimbursement

Our health care attorneys provide comprehensive assistance to health care clients in Medicare, Medicaid and third party reimbursement matters. We regularly assist health care providers in understanding and complying with the complex Medicare and Medicaid coverage and payment rules, and frequently advise our clients regarding the reimbursement implications of proposed business arrangements and service reconfigurations. We maintain excellent working relationships with representatives of the principal health care regulatory agencies.

Our lawyers regularly advise health care clients regarding the Medicare enrollment process, including their continuing obligations as Medicare participating providers and suppliers. We counsel our clients regarding change of information submissions required as the result of changes in ownership, mergers or other business transactions, or as a consequence of other reportable events that arise in the ordinary course of business. We also assist clients with post-application and development actions, including rejection, deactivation or revocation proceedings that can have serious reimbursement implications.

We also represent clients in Medicare and Medicaid payment and claim disputes, including payment denials resulting from contractor audits. We assist our clients with analyzing and interpreting the audit findings of consultants and auditors to ensure accurate audit results, and assist with the evaluation of trends or patterns that may demonstrate a systemic problem. In addition, we monitor federal and state health care legislation and assist our clients in having their interests heard and addressed. We regularly submit comments to proposed regulatory changes on our clients’ behalf and have also represented clients in specific Medicare reimbursement efforts, including by way of examples, Medicare Area Wage Index reclassification efforts and disproportionate share hospital payments (DSH), resulting in significant increases in funding.

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