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Medicare Reimbursement
A major part of the counsel we provide to healthcare clients relates to reimbursement under the Medicare and Medicaid programs, as well as other government healthcare programs. Our lawyers have extensive experience in advising healthcare clients and working with relevant agencies to resolve reimbursement issues.
The following are representative of the matters on which we regularly assist clients:
- Assisting clients with Medicare and Medicaid enrollment issues including obtaining necessary certification, updating enrollment information and working with intermediaries and carriers to facilitate claims processing.
- Interpreting and advising on Medicare claims submission and billing practice requirements including local and national coverage determinations, incident to billing provisions, reassignment requirements and billing for “physician extenders.”
- Counseling clients in developing “provider-based” facilities and organizations, and assisting clients in developing and filing related documents with the Centers for Medicare & Medicaid Services (CMS) including attestation materials.
- Counseling clients in developing and operating sole community hospitals, long-term acute-care hospitals, federally qualified health centers and other entities subject to special reimbursement programs under Medicare.
- Representing clients in Provider Reimbursement Review Board (PRRB) and Federal Employees Health Benefits (FEHB) appeals.
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