Health Care: Overpayment Proceedings
(Medicare, Medi-Cal, Denti-Cal)

REPRESENTING A PHYSICIAN

Background: Medicare sought over $270,000 in reimbursement from a physician for physician assistant billing, diagnostic billing and other extrapolated services.
Resolution: After an administrative hearing before the Centers for Medicare and Medicaid Services, our client’s overpayment amount was reduced to less than $35,000. (2005)

REPRESENTING AN INDEPENDENT
DIAGNOSTIC TESTING FACILITY

Background: Medicare sought over $200,000 in reimbursement from an independent diagnostic testing facility for services that were allegedly medically unnecessary.
Resolution: We submitted extensive declarations, medical records, and expert testimony. After the initial conference, the Centers for Medicare and Medicaid Services reduced our client’s overpayment amount to less than $30,000. (2005)