Medicare/Medicaid Reimbursement

Virtually every participant in the health care industry is affected by the Medicare and Medicaid programs. Medicare is the nation’s largest payor for health care, and the rules governing both Medicare and Medicaid reimbursement are complex and constantly changing.

Health care providers face a complex, evolving system of rules and regulations governing Medicare and Medicaid coverage and reimbursement for services. This increasing level of regulatory scrutiny poses significant challenges to providers' ability to continue profitable operating margins. Our consultants recognize the challenges that hospitals and health systems face, and work closely with clients to develop and implement legal strategies that increase their ability to achieve Medicare compliance while preserving Medicare reimbursement under the most current regulatory framework.

We monitor federal regulations and CMS clarification’s to analyze areas of reimbursement risk and emerging issues that may impact our clients. Because Medicare rules are constantly changing to reflect the current public opinion, political climate and state of the health care industry and medical research, our consultants are dedicated to keeping ahead of the curve by working with clients to identify issues, analyze proposed rules or modifications and propose meaningful solutions.