Capabilities

In Brief: A Digest of Medicaid Reimbursement Projects

Client Results

Assisted with development and operation of Medicaid upper payment limit (UPL) programs.
Performed Medicaid Disproportionate Share Hospital (DSH) analysis, application and payment appeals.
Advised healthcare providers on the impact of proposed state legislation, policy initiatives and industry changes, including Medicaid waivers.
Represented providers in Medicaid recoupment and audits.
Performed internal compliance investigations of suspected Medicaid overpayments.
Advised clients on provider donation rules, the Stark law, the federal Anti-Kickback Statute, civil monetary penalties, the False Claims Act and related state laws.
Developed Medicaid waiver programs in conjunction with state Medicaid offices and the Centers for Medicare and Medicaid Services (CMS) to more efficiently reimburse Medicaid providers.