Medicare and Medicaid Certification and Payment

For most healthcare providers, participation in the Medicare, Medicaid and other governmental healthcare programs represents both a source of financial gain and an area of financial risk.  Medicare and Medicaid programs apply extremely complex regulatory restrictions on  healthcare providers, in particular for participation in (certification) and payment from the programs. 

The Health Law Group has extensive experience in representing healthcare providers with Medicare and Medicaid payment, coverage and compliance issues.  While it is our belief that a client knows best about their particular business, The Health Law Group provides additional guidance and assistance in dealing with the complex regulatory and bureaucratic hurdles that providers face in participating in and being compensated by these governmental healthcare programs.


The type of clients we counsel regarding Medicare and Medicaid certification, payment and compliance issues include: 

  • Physicians and Physician Group Practices 
  • Independent Diagnostic Testing Facilities 
  • Ambulatory Surgery Centers 
  • Hospitals 
  • Clinical Laboratories 
  • Nursing Facilities 
  • Durable Medical Equipment Suppliers
  • Physical and Occupational Therapy Providers
  • Rehabilitation Services
  • Psychiatric Same Day Services
  • Federally Qualified Healthcare Clinics


Our services have included:

  • Regulatory and business advice on reimbursement issues
  • Appeals of payment and certification denials
  • Compliance review and analysis
  • Medicare Part A and Part B payment disputes
  • Representation in surveys and certification actions
  • Representation in audits, recoupment and overpayment demands
  • Obtaining and maintaining Medicare and Medicaid enrollment
  • Development of Corrective Action Plans