We regularly assist our health care clients with the vast array of regulations and agency policies and practices in licensure, certification and Medicare and Medicaid and private payor reimbursement issues.

Experience Highlights

Licensure & Certification – We advise clients on licensure and certification surveys, compliance investigations and penalty assessments and represent them in challenging adverse determinations. We frequently communicate on behalf of our clients with state licensure and certification agencies, fiscal intermediaries and the Centers for Medicare and Medicaid Services.

Reimbursement – We help our clients understand the reimbursement rules, represent them when the federal or state government seeks to recoup monies paid and deal with payment disputes between our clients and government and private payors.

Experience

• Represented a hospital client in an administrative appeal which resulted in the reversal of a decision by the state Medicaid agency to recoup hundreds of thousands of dollars
• Enjoined state Medicaid agency from imposing a rate reduction upon home care providers and convinced the agency through an administrative appeal to abandon the rate reduction
• Obtained decisions from an administrative law judge and a superior court judge preventing the state's Medicaid agency from imposing Medicaid program changes on the grounds that these changes violated state and federal law
• Settled numerous recoupment proceedings against our clients for substantially less than the agency initially sought to recover

News

• Andrea Heffernan Brisbin Joins Parker Poe
  June 23, 2006

Events

• Keeping a Finger on the Pulse of Your Practice
  October 29, 2010
  South Carolina Medical Association (SCMA) Fall 2010 Workshop, Mt. Pleasant, SC