Attorneys
- Lloyd Bookman
- Kelly Carroll
- Matthew Clark
- Sven Collins
- Paul Garcia
- Laurence Getzoff
- Stephanie Gross
- John Hellow
- Patric Hooper
- Jordan Kearney
- Scott Kiepen
- Joseph LaMagna
- Jeffrey Lin
- Nina Marsden
- Katrina Pagonis
- Arthur Peabody, Jr.
- Mark Reagan
- Robert Roth
- David Schumacher
- Erin Sclar
- Jeremy Sherer
- Stanton Stock
- David Vernon
- Catherine Wicker
Industry Leadership
Hooper, Lundy & Bookman’s provider reimbursement practice is nationally renowned. With more attorney years of Medicare and Medicaid reimbursement experience than any other firm in the country, we are able to provide our clients with unique insights and problem-solving capabilities unavailable elsewhere.
We represent more than 1,600 hospitals nationally in reimbursement matters, including the country’s largest multi-hospital systems, individual hospitals and teaching facilities, as well as small rural hospitals. In addition, we represent physicians, long-term care facilities, psychiatric and rehabilitation hospitals, home health agencies, laboratories and other types of providers.
Extensive Court And Regulatory Experience
Our attorneys have appeared in more than 50 different United States District Courts and most of the United States Courts of Appeals. The firm regularly conducts hearings of payment disputes before Medicare’s Provider Reimbursement Review Board, state Medicaid administrative law judges and state and federal courts throughout the country. These payment disputes have involved individual hospitals, statewide class actions and national efforts comprising more than 1,300 facilities.
We have represented health care providers in more Recovery Audit Contractor (RAC) appeals than any other law firm in the country.
Because our attorneys have been involved in many Medicare and Medicaid program changes over the last two decades, we have acquired a unique set of resources, including an extensive library of formal and informal agency rulings and guidelines not generally available. These resources are critical to interpreting complex provisions of the Medicare and Medicaid laws.
Key Industry Relationships
Our longevity and expertise in provider reimbursement have also resulted in our excellent relationship with payors and agency regulators. As a result, we are able to resolve the majority of disputes with federal and state agencies without resorting to lengthy litigation. When administrative or court action is necessary, however, our attorneys are experienced trial and appellate lawyers with the ability to pursue a client’s case through all phases of the regulatory hearing process and the trial and appellate courts.
Reimbursement And Payment Specialties:
Medicare Disputes
- Direct and Indirect medical education
- Outlier payments Diagnostic Related Group (DRG) Recoding
- Retroactive corrections to PPS rates
- Geographic reclassification
- Disproportionate share payments
- Wage index
- Labor and delivery room days litigation
- Malpractice rule litigation
- Return on equity litigation
- Medicare bad debt disputes
- Application of cost limits, exceptions, exemptions
Medicare Prospective Payment System Disputes
- Outlier payments Diagnostic Related Group (DRG) Recoding
- Retroactive corrections to PPS rates
- Geographic reclassification
- Disproportionate share payments
Medicaid Payment Disputes
- State-wide class actions
- State liability for Medicare cost-sharing
- Sufficiency of payment rates
- Medicaid state plan challenges
Individual Provider Payment Disputes
- Cost audit issues
- Cost limit application, calculation
- Disproportionate share hospital funding
- Distinct part skilled nursing status
- Sub-acute units
- Transitional care
- June 15, 2022
- April 11, 2022
- March 30, 2022
- February 28, 2022
- November 12, 2021
- October 29, 2021
- August 13, 2021
- June 17, 2021
- January 11, 2021
- December 8, 2020
- August 24, 2020
- May 7, 2020
- May 2, 2020
- April 29, 2020
- April 23, 2020
- April 22, 2020
- April 11, 2020
- March 31, 2020
- March 31, 2020
- March 30, 2020
- March 26, 2020
- March 20, 2020
- March 18, 2020
- February 26, 2020
- September 19, 2019
- September 4, 2019
- August 27, 2019
- July 31, 2019
- June 4, 2019
- April 17, 2019
- March 15, 2019
- February 22, 2019
- July 15, 2018
- July 14, 2018
- May 3, 2018
- January 1, 2018
- December 21, 2017
- December 11, 2017
- October 25, 2017
- August 16, 2017
- June 23, 2017
- May 26, 2017
- May 10, 2017
- March 6, 2017
- January 18, 2017
- November 17, 2016
- November 3, 2016
- October 18, 2016
- September 30, 2016
- August 1, 2016
- July 7, 2016
- June 1, 2016
- May 27, 2016
- May 3, 2016
- April 27, 2016
- April 15, 2016
- March 17, 2016BNA's Health Law Reporter
- February 11, 2016
- February 10, 2016
- February 5, 2016
- January 8, 2016
- December 17, 2015
- December 16, 2015
- August 12, 2015
- June 25, 2015
- May 20, 2015
- April 1, 2015
- April 1, 2015
- April 1, 2015
- March 17, 2015
- February 10, 2015
- January 9, 2015BNA's Medicare Report
- October 10, 2014
- April 28, 2014
- April 9, 2014
- April 3, 2014
- February 5, 2014
- January 13, 2014
- October 30, 2013
- August 20, 2013
- May 31, 2013
- April 22, 2013
- March 29, 2013
- February 9, 2013
- November 20, 2012
- May 15, 2012
- February 22, 2012
- February 19, 2012
- December 29, 2011
- December 28, 2011
- December 12, 2011
- October 7, 2011
- March 1, 2010
Health Law Perspectives
- September 27, 2019
- March 27, 2019
- February 2018
- October 15, 2017
- October 15, 2017
- November 15, 2016
- March 15, 2015
- February 1, 2014
Other Publications
- May 15, 2016
- April 15, 2016
- March 16, 2016
- September 3, 2015
- August 12, 2015
- HLB Economic Policy Advisor Alex Brill Analyzes the new rating systemMay 1, 2015
- HLB Medicaid Expert Lloyd Bookman shares his outlook on the outcome of the Court's decisionApril 2, 2015
- HLB Attorney James Segroves Provides Perspective on the Court's OpinionMarch 12, 2015
- January 9, 2015