Fenton Law Group works with providers who experience problems with their participation in the Medicare program, from enrollment issues to recovery audits. The incidence of Medicare recovery audits against healthcare providers is on the rise as the U.S. Department of Health and Human Services, Center for Medicare and Medicaid Services (CMS) has identified physician “overpayments” as a promising source of financing. Through the Recovery Audit Contractor (RAC) program and other initiatives, Medicare increasingly denies providers payments or audits them for alleged overpayments. The Medicare attorneys at Fenton Law Group regularly defend healthcare providers in Medicare Part B recovery audits and appeals, including Medicare audits by the administrative contractor (i.e. the carrier), formerly NHIC and, effective September 2, 2009, Palmetto GBA. In addition, Fenton Law Group has significant experience defending audits by the program safeguard contractor, Safeguard, LLC (formerly EDS/Cal-BISC), the RAC auditor, PRG Schultz, and other Medicare contractors. We have successfully assisted clients in all stages of the Medicare appeals process. Cases of note include:
While these success stories are no guarantee of results in any particular case, they are reflective of the thorough and tireless approach that Fenton Law Group Medicare attorneys use to defend physicians accused of overpayment by the Medicare Program. These examples highlight why Fenton Law Group is regarded as a premier Los Angeles Medicare law firm, at the forefront of health insurance in California, and leaders in defending Medicare providers in California. In addition to defending recovery audits, Fenton Law Group attorneys also advise providers in navigating complex Medicare and Medi-Cal issues and in Medicare compliance, including Medicare enrollment issues and Medicare Secondary Payor (MSP) issues. Fenton Law Group has also successfully defended providers from claims by private health plans and private payor auditors (such as the Rawlings Group) who attempt to force providers to refund reimbursement based on patient Medicare coverage.
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If you have a time sensitive issue that needs to be addressed, please call us at (310) 444-5244.