Reimbursement

Since the inception of our Firm, we have routinely counseled our clients concerning Medicare and Medicaid reimbursement issues. Challenging adverse reimbursement determinations has never been a simple process, and budgetary constraints have resulted in unprecedented pressure on the government to drive down reimbursement rates even further. In addition, providers are now facing a new array of issues due to the expansion of the federal government’s audit programs, such as the Medicare Recovery Audit Contractor (RAC) program, the Medicaid Integrity Contractor (MIC) program, and the Zone Program Integrity Contractor (ZPIC) program. We are widely recognized as effective advocates for our clients on payment issues, particularly in the post-acute care community. We routinely assist our clients in challenging adverse Medicaid reimbursement decisions made by Pennsylvania Department of Public Welfare (DPW ) and claims denials issued by Medicare contractors. In every reimbursement matter, our goal is provide zealous representation while remaining sensitive to our client’s business considerations.