Reimbursement and overpayment audit defense

Our attorneys provide advice and counsel to virtually all types of health care providers and professionals on reimbursement issues and payor audits and recoveries, including Medicare and Medicaid reimbursement, coverage and compliance issues. As the result of our depth and range of experience, we can quickly analyze reimbursement issues and provide the guidance our clients need to correctly bill and receive timely payment for their goods and services.

We understand the payment policies underlying the different systems of reimbursement for health care providers and the different rules and requirements necessary to accurately code and bill for services, whether under one of the prospective payments systems or on the basis of a fee schedule. As a result, we are able to counsel clients in a clear and concise manner and minimize compliance risks. Our attorneys regularly assess compliance risks resulting from the application of Medicare and Medicaid payment rules to their health care operations, including internal audits of compliance issues when necessary. We also advise clients on the implications of their conduct under the False Claims Act and fraud and abuse laws, and regarding the return of any identified overpayments and the process for correcting any underpayments.

Our attorneys represent health care clients in administrative and judicial proceedings with a variety of federal and state agencies and insurance companies in connection with reimbursement disputes and audits and defend those clients against overpayment demands and recoupment efforts.