In litigation and negotiations, the firm represents providers in disputes with the Center for Medicare and Medicaid Services (“CMS”) and its intermediaries and carriers, as well as other governmental agencies, such as the Department of Labor and the Office of Inspector General (“OIG”). The firm has also represented clients in disputes involving certification issues, administrative appeals of claim denials, challenges to medical review policies and civil and criminal investigations for fraud and abuse.

Some of the litigation by the firm and/or its attorneys has involved issues that are of significance to health care providers:

In the Case of Global Home Care, Inc., Docket No. M-11-116 (Medicare Appeals Council 2011) (Challenge to statistical sampling used in clinical audit).

In the Appeal of First Choice Home Health., ALJ Appeal No. 1-464274171 (Appeal of a Program Safeguard Contractor Audit).

In the Case of Marias Medical Center, PRRB Decision No. 2008-D40 (2008) (Standby costs for a Certified Registered Nurse Anesthesiologist by a Critical Access Hospital).

Chao v. A-One Medical Services, Inc., 346 F.3d 908 (9th Cir. 2003) (Legal standards for joint employment and willfulness under the Fair Labor Standards Act).

Elwell v. University Hospitals Home Care Services, 276 F.3d 832 (6th Cir. 2002) and 76 F.Supp.2d 905 (N.D. OH 1999) (Standards for compensating RNs by the Fee Basis of payment).

VNA of Southwest Indiana, et al. v. Shalala, 213 F.3d 352 (7th Cir. 2000) (Challenge to IPS related overpayments based on Medicare’s Waiver of Liability).

Western Illinois Home Health, Inc. v. Reich, 150 F.3d 659 (7th Cir. 1998) (Challenge to Department of Labor’s decision to collapse certified and private duty agencies as joint employers).

Ohio Council for Home Care, Inc. v. Ohio Department of Human Services, No. 94-03530 (Ohio Court of Claims 1997) (Class action challenging Ohio’s Medicaid reimbursement scheme).

Cox v. Acme Health Services, 55 F.3d 1304 (7th Cir. 1995) (Litigation involving the parameters of the Companionship Services exemption to the Fair Labor Standards Act).

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