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Attorneys in the Healthcare Department’s reimbursement practice have handled a myriad of reimbursement matters and claims denial cases for hospitals and health systems, physicians and physician group practices, ambulatory surgery centers, nursing homes and other healthcare providers. We have extensive experience challenging all types of federal and state reimbursement issues, including those pertaining to Medicare and Medicaid cost reporting and federal disproportionate share hospital reimbursement, as well as state subsidy fund payments, such as payments for charity care, graduate medical education, hospital relief, and mental health.

Our attorneys regularly represent hospitals and other providers, both individually and in group appeals, challenging reimbursement issues before the Provider Reimbursement Review Board (PRRB), state administrative agencies, and in federal and state courts, including defending our healthcare clients in Federal False Claims Act and state insurance fraud cases, as well as investigations by the Medicaid Fraud Division.

Representative Matters

Lawyers in our reimbursement practice have had leading roles in the following Medicare/Medicaid/disproportionate share hospital reimbursement matters:

Our attorneys have prosecuted significant Medicare and Medicaid appeals from the administrative level through the federal appellate courts. Our experience includes issues involving: