With healthcare providers under increasingly aggressive attack from Medicare, Medicaid, and private insurers seeking repayment for alleged overpayments, CMM is proud of its track record in fighting back. 

 

The firm recently represented a physician targeted by Medicare, through its Recovery Audit Contractor (RAC), to repay $850,000 in fraudulent billings.  Our team was able to show that our client worked for a podiatrist who pled guilty to healthcare fraud in a prosecution by the U.S. Attorney for the Eastern District of New York.  We provided evidence of his admission that he used our client's Medicare provider number to submit his own false billings. Based on this evidence, Medicare's Victimized Provider Project agreed to investigate and determined that our client was indeed the victim of identity theft.  Medicare ultimately ceased all efforts to collect the $850,000 from our client, saving her from certain bankruptcy. 

 

"This case highlights the importance of thoroughly investigating and documenting any unauthorized use of Medicare billing credentials," said Bill McDonald, chair of CMM's Healthcare department.  "Providers can also benefit from the investigatory experience an attorney brings to protect against liability from unauthorized billings."