Medicare & Medicaid

Across today’s expanse of compliance and operational challenges.

As Medicare/Medicaid populations continue to grow, their respective policies and procedures become increasingly complex. Feldesman Health Care attorneys routinely counsel clients on compliance issues that can affect federal grant status — along with payment, financing and managed care arrangements. Additional services include representation in Medicaid waiver negotiations and overall operations advisory.

Our attorneys have handled numerous client matters involving Medicare and other government health insurance programs. Representative matters include:

• Compliance with Medicare conditions of coverage;
• Enrollment for new site locations following merger or acquisition;
• Graduate Medical Education payment requirements including billing for services furnished by medical residents at teaching health centers;
• Resolution of program integrity concerns including refunding overpayments;
• Medicare Advantage contracting strategies for FQHCs;
• Value-based care initiatives such as ACOs and DCEs;
• Coinsurance collection and fee-setting including unique requirements concerning FQHC PPS under Medicare;
• Billing for “special” Medicare services, such as telehealth, virtual communication services and chronic care management

As with our other areas of experience, our representation of health care organizations on Medicare matters such as those listed above runs the gambit from counseling and regulatory advice, self-disclosures and audit defense to administrative and judicial litigation.