Blog

Claims Appeal Results in Reversal of Alleged Medicaid Overpayment

Posted on Firm News December 5, 2017 by Parker Eastin

After submitting a detailed appeal on behalf of our client’s medical practice, the Firm secured a complete reversal of an overpayment demand from the Medicaid contractor.  The Medicaid contractor initially challenged the coverage for the allergen immunotherapy services provided by the medical practice.  However, after addressing the support for the allergy services found in the Read more →

Firm Helps Chiropractic Clinic Successfully Hold Off Audit by Supplemental Medical Review Contractor

Posted on Firm News November 14, 2017 by Erin Ferber

As part of its fight against fraud, waste and abuse, CMS contracted with supplemental medical review contractors to perform and/or provide support for a variety of tasks, including performing audits.  As part of their responsibilities, these contractors perform audits to identify overpayments.  Among the many projects being worked by these contractors, is a current review Read more →

Department of Justice Obtains $400k Settlement Based Upon Failure to Timely Repay a Known Overpayment

Posted on Firm News November 14, 2017 by Robert Nicholson

On October 13, 2017, the Department of Justice announced a False Claims Act settlement with First Coast Cardiovascular Institute, a Florida based health clinic, under which the practice will pay $448,821.58 for failing to timely refund $175,000 in overpayments to Medicare, Medicaid, TRICARE, and the Department of Veterans Affairs. The settlement is noteworthy because it Read more →

License Investigation Against Chiropractor Closed with Letter of Guidance

Posted on Firm News November 14, 2017 by Erin Ferber

The Firm successfully defended a Chiropractor against allegations that the Chiropractor had engaged in billing fraud and used inadequately trained personnel to provide certain services. The Firm investigated the allegations at issue and prepared a response to the investigative complaint that highlighted evidence that demonstrated that the Chiropractor had acted properly, had not engaged in Read more →

License Investigation Against Licensed Mental Health Counselor Closed with Finding of No Probable Cause

Posted on Firm News November 3, 2017 by Parker Eastin

The Firm successfully defended our LMHC client against allegations that the LHMC engaged in unprofessional conduct; misdiagnosed a client; and engaged in excessive UA testing.  This result is especially notable because the complaint at issue was initiated by a competing provider in the community. The Firm investigated the allegations at issue and prepared a rebuttal Read more →

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