Experience

Medicaid Appeal—$95 Million Recovery

Developed and prosecuted coordinated Medicaid appeals and litigation on behalf of a group of hospitals that resulted in a landmark settlement of approximately $95 million with the State.

Standardized Amount Appeal

Engaged by several large health systems to pursue the "standardized amount" appeal on their behalf at the Medicare Provider Reimbursement Review Board (PRRB), either through group appeals where allowed, or through individual appeals.

Graduate Medical Education

Obtained multi-year addition to teaching hospital's Graduate Medical Education cap and Medicare reimbursement through appeal to the PRRB.

Medicare Appeal—$33.5 Million Recovery

Represented group of 19 hospitals in appeals before the PRRB involving over 120 fiscal years, resulting in on-going settlements worth approximately $33.5 million.

Medicare Appeal—$27 Million Recovery

Worked on behalf of two related teaching hospitals in multiple appeals of Medicare disallowances filed before the PRRB covering multiple fiscal years, culminating years of work in a full and complete settlement with our clients recovering approximately $27 million.

Medicare Appeal—$6 Million Recovery

Represented a large hospital before the PRRB covering four fiscal years, resulting in over $6 million of additional Medicare reimbursement to the hospital.

State Medicaid Audits

Defended numerous state Medicaid audits alleging substantial overpayments, including a $3.6 million alleged overpayment resolved for $350,000 and a $530,000 alleged overpayment settled for $823, among others.

Overpayment—Physician Practice

Worked with a physician practice in an alleged overpayment of over $400,000, resolving the matter with a payment of only $30,000.

Overpayment—FQHC

Investigated and reported a Medicare overpayment to the Centers for Medicare & Medicaid Services (CMS) on behalf of a federally qualified health center.

Reasonable Cost Reimbursement

Persuaded CMS to agree that a certain type of allied health residency program met the Medicare criteria for "reasonable cost" reimbursement.

Medicare Payment

Advised health systems on coping with evolving Medicare payment rules and maximizing payments through organizational strategies and where necessary.

Internal Investigation

Conducted internal investigation into causes and extent of billing and documentation errors by hospital personnel for Medicare short-stay admissions.

Firm Highlights

Publication/Podcast

Amending Your Retirement Plans this Year for SECURE Act and CARES Act Changes

This post was updated on September 29, 2022. On August 3, 2022, the IRS extended the deadline for retirement plan sponsors to adopt amendments necessary to comply with the Setting Every Community Up for...

Matter

Elections and Constitutional Law: Successfully Challenged Certification of Initiative Petition

In a victory for consumers and the ride-hailing public, the Massachusetts Supreme Judicial Court recently barred the Secretary of State from placing on the November ballot initiative petitions proposed by companies such as Uber...

Event

Annual Update: Part 1 - 2022 Legal Year in Review (1st Session)

Matter

Advised Fortune 500 Company on Group Health and Welfare Benefit Plans

We were engaged by a Fortune 500 manufacturing company to provide legal and compliance services regarding its group health and welfare benefit plans. During the course of our representation, we have advised the company...

News

The Boston Bar Association Adds Verrill Attorney David M. Friedman to Council

Publication/Podcast

BLM-Masked Employees of Whole Foods Lose Race Bias Appeal Regarding Dress Code

Event

Annual Update: Part 1 - 2022 Legal Year in Review (2nd Session)

Blog

Verrill Partner Mat Todaro selected to serve on the American Bar Association’s Section on Environment, Energy, and Resources 2022 Fall Conference Planning Committee

Earlier this year, Verrill Partner Mat Todaro was selected by American Bar Association leadership to serve on the 2022 Fall Conference Planning Committee for its Section on Environment, Energy, and Resources. In this role...

News

Verrill Attorney Elizabeth Connellan Smith Elected President of National Workers’ Compensation Defense Network

Blog

Proposed Changes to Massachusetts Paid Family & Medical Leave Regulations

The Massachusetts Department of Family and Medical Leave has proposed changes to the regulations governing the state’s paid family and medical leave program. The proposed changes are intended to clarify the requirements related to...

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