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Capabilities / Medicaid Reimbursement Strategies

Medicaid Reimbursement Strategies

Leveraging custom-built solutions.

The attorneys on Husch Blackwell’s Healthcare team have a thorough understanding of the complex laws and regulations that drive Medicaid reimbursement. By constantly monitoring state reimbursement frameworks and proposed rule and policy changes, we are able to develop strategies that leverage current and pending regulations and optimize Medicaid reimbursement.

All reimbursement programs eventually interact and impact one another on a macro level. Our individualized strategies ensure that increasing reimbursement from one source will not result in decreased reimbursement from another. Our experience also includes reviewing and negotiating agreements between payors and providers, billing and claims issues, fraud and abuse, and reimbursement disputes.

Representative Experience

  • 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.
News Releases | April 01, 2022
Husch Blackwell Adds Two Healthcare Partners to Virtual Office

Husch Blackwell is pleased to announce that Lisa T. Thomas and Bryan Stewart have joined the firm’s Healthcare, Life Sciences & Education industry group as partners.

News Releases | May 22, 2019
Drew Canning Joins Husch Blackwell's Kansas City Office

Canning comes to Husch Blackwell from the largest pharmacy benefit management organization in the country, where he worked on regulatory issues, compliance, and client solutions.

Husch Blackwell “wins acclaim among market sources for its ability to combine technical acumen with practical application.” The firm “represents an array of healthcare providers in regulatory compliance, transactional and operational issues, including Medicare/ Medicaid reimbursement work.

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