Medicare Overpayment Successfully Challenged
Posted on Firm News March 14, 2012 by author
Threatened Medicare overpayments against 4 physicians amounting to several hundred thousand dollars abandoned by Medicare after Nicholson & Eastin, LLP appeal to CMS over erroneous interpretation of coverage determination by the Medicare carrier. Robert Nicholson, managing attorney of the firm, travelled to CMS headquarters to make the case that the Medicare carrier was misapplying the national coverage determination regarding the specialty treatment. The firm demonstrated, based upon an analysis of the history of the procedure, the history of the coverage determination, and an understanding of the medicine, that the coverage exclusion did not apply to the procedure as the Medicare carrier had determined.