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Administrative Appeals Medicare Administrative Contractors (MAC)

Maynard Nexsen

Proactive Coding Compliance: The Best Way to Avoid the CMS Administrative Appeal Process

Maynard Nexsen on

As an attorney specializing in healthcare reimbursement, I have focused my practice on helping healthcare providers navigate the Center for Medicare and Medicaid (“CMS”) administrative appeal process. I usually get a call...more

Robinson+Cole Health Law Diagnosis

Fifth Circuit Reinstates Provider’s Collateral Challenge to the Medicare Appeal Process

On March 27, 2018, the United States Court of Appeals for the Fifth Circuit held that a health care provider can seek an injunction in federal court against recoupment by Medicare of alleged overpayments despite not...more

King & Spalding

PRRB Releases New Reinstatement Rules

King & Spalding on

Effective July 1, 2015, the Provider Reimbursement Review Board (PRRB or Board) has promulgated new rules regarding the reinstatement and withdrawal of appeals before the Board. The most significant change is a new rule...more

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