Lawyers in this section of the Health Care practice represent Durable Medical Equipment (DME) providers, Home Health Agencies (HHAs), Pharmacy Infusion providers, and medical equipment manufacturers throughout the country. These attorneys are well-versed in areas of federal reimbursement and billing, fraud and abuse, and contracting. In addition, they regularly deal with commercial insurers and governmental regulatory and enforcement entities, such as the National Supplier Clearinghouse (NSC), DME Medicare Administrative Contractors (MACs), state Medicaid offices, HHS’s Office of the Inspector General (OIG), the Department of Justice (DOJ), Medicare Fiscal Intermediaries, and the Centers for Medicare and Medicaid Services (CMS).
Our lawyers regularly publish articles in state and national journals on topics that are germane to the industry, such as National Competitive Bidding, IDTF rules, oxygen caps, and Medicare audits. Additionally, lawyers in this section are frequently invited to speak at state and national conferences put on by manufacturers and trade associations. Thompson Coe also puts on its own educational conferences and sponsors industry seminars to keep clients updated on regulatory and legislative changes.
Thompson Coe serves as legal counsel to several national professional and trade associations. For many of these association clients, we serve as general counsel (e.g., Texas Association of Home Care Services (TAHCS)).
Our practice includes representing clients in cases involving, among others:
- Appealing Medicare pre-payment or post-payment audits
- Assessing risks and benefits of DMEPOS National Competitive Bidding Program
- Drafting business associate agreements to be in compliance with HIPAA HITECH
- Assisting with surety bond issues
- Interpreting new statutes and regulations
- Assisting with accreditation issues
- Negotiating contracts for third-party reimbursement, including Medicare, Medicaid, and private insurance
- Arguing before various Administrative Law Judges during provider appeal
- Reviewing contracts for compliance with Stark and Anti-Kickback issues
- Appealing Medicare overpayment determinations and payment denials
- Interpreting 2010 National Coding Standard for Home Infusion Claims Under HIPAA
- Assisting in PECOS online transition
- Defending providers for failure to comply with Medicare Supplier Standards
- Recovery Audi Contractors (RAC) Appeals; ZPIC/PSC Appeals.