Medicaid Cost Reimbursement Report Denials

The Health Law Firm and its legal professionals represent health care providers in virtually every aspect of Medicaid program audits, investigations and litigation. These include physicians, medical groups, mental health professionals, pharmacies, nursing homes, home health agencies, hospitals and other health facilities.

It is extremely important that the health care provider obtain experienced professional representation in responding to a Medicaid Program audit notice. There are many problematic legal issues that a Medicaid audit seeks to identify in such audits. Correct responses to audit questionnaires and the provision of complete, legible, well-organized, responsive medical records (and other supporting documentation) must be provided. This is crucial from the very beginning.

The receipt of the Provisional Agency Audit Report (PAAR) is another opportunity to provide documents, explanations, medical authority, legal authority and other documentation that may reduce or eliminate any repayment to the Medicaid Program.

After receipt of a demand for an overpayment that may be alleged to be due to the Medicaid Program (in Florida, administered by the Florida Agency for Health Care Administration or "AHCA," and its contractors), it may still be possible to negotiate a repayment or settlement of the matter on favorable terms.

If not, then The Health Law Firm and its attorneys are experienced in representing the health care provider in formal administrative hearings, in civil litigation or in appeals, on such matters.

Our attorneys are experienced in handling appeals of denials of Medicaid Cost Reimbursement Reports for health care providers.

We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, and other experts that assist us in such matters.

In the event that a health care professional receives a subpoena or search warrant for records concerning a Medicaid criminal investigation, our attorneys are experienced in dealing with investigators and state's attorneys, including attorneys and investigators working for the Attorney General's Medicaid Fraud Control Unit, in defending the health care provider and attempting to resolve the case before criminal charges are filed.

We assist providers in obtaining Medicare and Medicaid provider status (provider identification numbers), as well as, in proceedings seeking to revoke or terminate a health care provider's Medicare and Medicaid provider status. We also advise clients on performing internal audits of Medicare and Medicaid services, billing, reimbursement and on how to make voluntary refunds of overpayments to the Medicare and Medicaid Progams.

Main Office • 1101 Douglas Avenue, Altamonte Springs, FL 32714
Orlando Branch Office • 37 N. Orange Ave., Orlando, FL 32801
Pensacola Branch Office • 201 E. Government St., Pensacola, FL 32502
Telephone: (407) 331-6620 & (850) 439-1001 • Telefax: (407) 331-3030

Available in the following Florida cities and counties: Daytona Beach, Fort Lauderdale, Gainesville, Jacksonville, Key West, Melbourne, Miami, Ocala, Orlando, Pensacola, Panama City, Sarasota, St. Petersburg, Tallahassee, Tampa, West Palm Beach, Alachua, Baker, Bay, Bradford, Brevard, Broward, Calhoun, Charlotte, Citrus, Clay, Collier, Columbia, Dade, De Soto, Dixie, Duval, Escambia, Flagler, Franklin, Gadsden, Gilchrist, Glades, Gulf, Hamilton, Hardee, Hendry, Hernando, Highlands, Hillsborough, Holmes, Indian River, Jackson, Jefferson, Lafayette, Lake, Lee, Leon, Levy, Liberty, Madison, Manatee, Marion, Martin, Monroe, Nassau, Okaloosa, Okeechobee, Orange, Osceloa, Palm Beach, Pasco, Pinellas, Polk, Putnam, St. Johns, St. Lucie, Santa Rosa, Sarasota, Seminole, Sumter, Suwannee, Taylor, Union, Volusia, Wakulla, Walton, and Washington

Available in the following states*: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming

*see "Available in the Following States" page for any limitations on representation
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