The Centers for Medicare & Medicaid Services ("CMS"), the federal agency within the United States Department of Health and Human Services ("DHHS"), administers the Medicare program and partners with state governments to administer Medicaid. Recent health care reform initiatives have resulted in increased scrutiny of Medicare and Medicaid payments made to hospitals, health care institutions, billing companies and physician practices, necessitating the need for skilled health care attorneys.

 

The CMS audit process has changed dramatically. Many healthcare providers, upon receiving notification from CMS or a Program Contractor of an impending audit, are uncertain how to prepare and proceed through this complex audit process. Our firm has the skills and experience to effectively analyze, respond to, and appeal complex Medicare and Medicaid reimbursement disputes.

Fraud & Abuse

Health care providers, practice groups, or billing companies can experience devastating consequences if charged with mishandling government funds, fraud, abuse, and/or billing improprieties. Our attorneys and litigators work closely with health care entities to effectively address all aspects of a claim and achieve results that further our clients' business objectives.

Internal Investigation

If a corporation suspects internal wrongdoing, or one of its employees, vendors, or contractors has reported an impropriety, we have the necessary skills to conduct internal investigations and provide sound legal advice for handling such matters.

 

It is critical that companies identify and effectively respond at the earliest indications that they or their employees may have violated health care billing laws. Our business acumen combined with our prior prosecutorial experience allows us to help clients discover and address unrecognized areas of risk before they become a problem, and to effectively communicate our clients' perspectives to, and address the concerns of, regulators and prosecutors.