Payments/Reimbursement

Overview

Our reimbursement attorneys have extensive experience with public and private payment systems of all varieties. We provide expert representation in navigating complex non-governmental payment methodologies, negotiating contracts, and resolving underpayment and overpayment disputes. Our services include:

  • Representing individual providers and groups in appeals before the Medicare PRRB and in federal trial and appeal courts, including appeals concerning DSH, GME, IME, bad debts, wage index adjustments, provider tax, and TEFRA
  • Representing health care providers in the resolution of public and private payment system disputes through mediation and arbitration
  • Prosecuting Medicaid appeals in state administrative hearings
  • Defending providers in audit overpayment determinations by MACs, RACs, state program integrity units, and private payers
  • Advising in connection with revenue cycle procedures, billing practices, coverage issues, and other aspects of payment compliance
  • Providing counsel concerning the 340B program and the cost principles governing Public Health Service grants