Successful Defense of Home Health Agency in Overturning Extrapolated Overpayment Resulting from Medicare Claims Audit

We successfully defended a home health agency in appealing a $9.3 million extrapolated overpayment resulting from a Zone Program Integrity Contractor (“ZPIC”) audit. Through the Medicare claims appeal process, we successfully argued that the statistical sampling methodology was invalid and should be set aside, resulting in the demand being reduced to under $175,000 before individual claims arguments were considered.

You Also May Be Interested In:

  • We successfully defended a national home healthcare provider in appealing an $18 million extrapolated overpayment resulting from a UPIC audit.

    We successfully defended a national home healthcare provider in appealing an $18 million extrapolated overpayment resulting from a UPIC audit....
    Client Type: Public Company
  • Representation of Addus HomeCare Corporation (NASDAQ: ADUS) in its $29.1 million acquisition of three affiliated entities: Armada Skilled Home Care of New Mexico, LLC, Armada Hospice of New Mexico, LLC and Armada Hospice of Santa Fe, LLC. This acquisition expands Addus HomeCare’s home health and hospice services in the state of New Mexico.

    We represented Addus HomeCare Corporation (NASDAQ: ADUS) in its $29.1 million acquisition of three affiliated entities: Armada Skilled Home Care...
    Client Type: Public Company
  • Representation of Gryphon Capital-backed Physical Rehabilitation Network (PRN), a leading physical therapy provider and practice management organization, in its acquisition of Complete Balance Solutions Institute for Physiotherapy Inc. through its joint venture with MemorialCare, a prominent non profit Southern California integrated health system. The transaction includes the acquisition of Complete Balance Solutions’ three Southern California outpatient therapy clinics and creates the region’s most expansive network of physical therapy facilities with 26 clinics throughout the region.

    We represented Gryphon Capital-backed Physical Rehabilitation Network (PRN), a leading physical therapy provider and practice management organization, in its acquisition...