News & Analysis as of

OMHA Due Process

Arnall Golden Gregory LLP

Texas Court Addresses Procedural Due Process Claims Caused by “Door-Closing” Recoupments and Calls for Elevated Safeguards to...

On January 15, 2020, Judge Kincaide granted Family Rehabilitation Inc.’s (“Family Rehab”) Summary Judgment Motion on its Application for Permanent Injunctive Relief finding that Family Rehab (1) achieved success on the merits...more

Arnall Golden Gregory LLP

Momentum is Building: Another Federal Court Stops Recoupment During a ZPIC Appeal, Citing Backlog in Medicare Appeals Process as...

Medicare’s implementation of post-payment review through overly aggressive zone program integrity contractors (ZPICs) and unified program integrity contracts (UPICs), combined with an ineffective review process at the first...more

Arnall Golden Gregory LLP

AGG Helps Hospice Weather the Perfect Storm of Aggressive Medicare Payment Denials and Administrative Appeal Backlog

Medicare’s implementation of post-payment review through private contractors who are overly aggressive in denying payments, combined with a severe backlog of cases in queue for hearing before an Administrative Law Judge...more

Sheppard Mullin Richter & Hampton LLP

A (Second) Lawsuit Seeks to Compel Statutory Timeframe for Administrative Law Judge Review of Medicare Claims Appeals

On August 26th, the Center for Medicare Advocacy filed a nationwide class action lawsuit against the Secretary of Health and Human Services. The complaint alleges that, as implemented, the Medicare administrative review...more

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