Zaina represents hospice providers in government audits and reimbursement disputes, helping safeguard payments for end-of-life care.
Her practice is focused on the hospice industry, giving her deep familiarity with evolving audit methodologies and insight into enforcement trends. She works in an increasingly active enforcement environment, where Centers for Medicare & Medicaid Services (CMS) and contractor-led audits challenge patient clinical eligibility and documentation compliance to seek repayment for hospice services already provided. In this context, she helps hospice providers navigate appeals and dispute audit findings, including overpayment determinations that threaten critical funding.
As a leader on the firm’s Hospice & Palliative Care team, Zaina works alongside a dedicated group of practitioners with substantial experience in this area, enabling coordinated strategies across both routine and complex matters. She regularly assists clients through audits of all kinds, including Targeted Probe and Educate (TPE) reviews; program integrity audits performed by Unified Program Integrity Contractors (UPICs), Supplemental Medical Review Contractors (SMRCs), and CMS’s Center for Program Integrity (CPI); and consequential prepayment audits such as Provisional Period of Enhanced Oversight (PPEO) reviews and expanded prepayment reviews. She assists clients with record production and throughout the full administrative appeals process, from redetermination through administrative law judge hearings and beyond.
In addition to audit defense and appeal strategy, Zaina advises hospice providers on regulatory compliance and documentation of best practices, helping prevent or overturn claim denials related to the Medicare conditions of payment. Her work helps clients mitigate risk, withstand government scrutiny, and maintain compliance frameworks that support their mission of serving vulnerable, terminally ill patients.
Zaina takes a collaborative approach, working closely with in-house compliance teams and executive leadership to tailor strategies to each matter. Clients value her thoroughness, responsiveness, and empathy, grounded in her deep familiarity with hospices and the unique, ever-increasing challenges they face. Her advanced training in health administration (MHA) and business (MBA) reflects her long-standing dedication to the healthcare field, a path inspired by her family’s background in medicine.