For medical care providers billing through Medicare, CMS has established elaborate procedures for appealing adverse determinations first by contractors, then by CMS, before an Administrative Law Judge, and finally through litigating in Federal Court. We are experienced in handling these appeals at the various stages, in an aggressive fashion, to defend against administrative excesses.
Often, further adverse administrative action with devastating consequences can often by avoided by preparation of a CORRECTIVE ACTION PLAN (“CAP”) to address the administrative concerns. We often pursue the simultaneous track of appealing adverse determinations along with preparation of a CAP and attempting to have it approved to forestall further administrative problems.
It is an unfortunate fact of corporate life that litigation, whether before State or Federal administrative agencies, or in Federal Court, is sometimes necessary. The firm brings decades of experience before such tribunals to its clients in order to represent their interests. While the firm seldom counsels its clients to be the aggressors in dealing with State Departments of Insurance or CMS, because today’s insulted and offended regulator is tomorrow’s problem and a potential antagonist, we vigorously represent our clients’ interests to provide maximum protection for them.