Leslie Demaree Goldsmith
Leslie Demaree Goldsmith has more than 30 years of experience grappling with Medicare reimbursement issues. She has advised healthcare providers on reimbursement questions involving prospective payment systems (PPS), provider-based status, co-location, wage index, bad debt, quality data, medical education (including Graduate Medical Education (GME), Indirect Medical Education (IME), nursing and allied health), disproportionate share hospital (DSH) calculations and cost allocation. She provides guidance to healthcare providers, including hospitals, home health agencies, hospices and skilled nursing facilities, on challenges involving conditions of payment and conditions of participation regulations.
Leslie has represented many healthcare providers before the Provider Reimbursement Review Board (PRRB) and the Centers for Medicare & Medicaid Services (CMS) Administrator, as well as in federal courts.
Leslie also guides clients on billing and claims issues, such as the Two-Midnight rule, quality reporting, telemedicine, the 340B program and Medicare bundled payments. She provides advice on compliance issues related to potential overpayments and the False Claims Act (FCA) involving allegations of improper billing and fraudulent cost reports.
Leslie is the author of numerous articles on healthcare topics that have been published in legal and healthcare financial journals and is a frequent speaker at industry conferences.
Memberships
American Health Law Association (AHLA)
American Bar Association
Maryland State Bar Association
Maryland Chapter of the Arthritis Foundation — Board of Directors (1998–2003); Public Policy & Advocacy Committee, Chair (1999–2004)
Publications
Upcoming Events
Past Events
Media Mentions & Firm News
Additional News & Insights
Publications
- “Supreme Court Agrees to Hear Two Medicare Payment Cases Next Term with Significant Financial Implications for Hospitals,” Westlaw (August 5, 2021)
- “Federal Court Strikes Down CMS Direct Graduate Medical Education Payment Regulation That Reduced Count of Certain Residents,” Westlaw (July 6, 2021)
- “CMS Issues Proposed Retroactive DSH Rule Requiring Medicare Part C Days in the Medicare Fraction and Blocks Providers’ Appeals through Ruling,” Lorman Educational Services (October 2020)
- “Federal District Court Upholds CMS Hospital Price Transparency Rule, Reporting to Begin January 1, 2021,” Westlaw (August 5, 2020)
- “D.C. District Court Issues Two Decisions Addressing CMS’s Medicare Bad Debt “Must Bill” Policy – One Rejecting the Policy and the Other Upholding the Policy,” F2 Healthcare (November 2019)
- “Provider Reimbursement Review Board Revises Rules, Effective Immediately,” (co-author) AHLA Weekly (September 2018)
- “Medicare Payment Changes for ‘New’ Off-Campus, Provider-Based Sites – CMS Publishes Final Rule and Congress Provides Some Relief,” (author) ABA Health eSource, Vol. 13, No. 6 (February 2017)
- “First Ed., Chapter: Medicare Reimbursement – Inpatient/Outpatient Hospitals,” (chapter editor) Representing Hospitals and Health Systems Handbook, American Health Law Association (2016)
Presentations
- “The PRRB’s Electronic Appeals Process,” HFMA Metro New York Chapter (April 2021)
- “PRRB Appeals: Current Topics,” Institute on Medicare and Medicaid Payment Issues, American Health Law Association (2021)
- “Legal Update: OIG Work Plan and Medicare Reimbursement Update,” Metropolitan New York Chapter, Healthcare Financial Management Association (February 2019)
- “OIG Work Plan and Medicare Reimbursement Update,” Regulatory and Reimbursement Update, Northeast Pennsylvania Chapter, Healthcare Financial Management Association (October 2018)
- “PRRB Appeals: Current Challenges,” Institute on Medicare and Medicaid Payment Issues, American Health Law Association (2018, 2019)
- “OIG Work Plans and Medicare Appeals Update,” Regulatory and Reimbursement Update, Northeast Pennsylvania Chapter, Healthcare Financial Management Association (October 2017)
- “OIG Work Plans and Medicare Appeals Update,” Regulatory and Reimbursement Update, New Jersey Chapter, Healthcare Financial Management Association (September 2017)
- “Recent Cost Reporting Appeal Issues – PRRB and CMS Administrator Decisions,” Institute on Medicare and Medicaid Payment Issues, American Health Law Association (2012–2017)
- “Provider-Based Reimbursement Reform,” Regulatory and Reimbursement Update, New Jersey Chapter, Healthcare Financial Management Association (2016)
- “Current Hot Issues in Medicare Reimbursement,” Ninth Annual Fall Institute, Philadelphia Chapter, Healthcare Financial Management Association (2015)
- “Medicare Wage Index Update,” Institute on Medicare and Medicaid Payment Issues, American Health Law Association (2007–2010)
Accolades
The Best Lawyers in America© — Health Care Law (2021-2023)
Who’s Who Legal — Healthcare (2020-2021)
JD Supra Readers’ Choice Award — Top Authors in Health Law (2016-2017)
Nightingale’s Health Care News — “Outstanding Hospital Lawyers” (2009)