Our practice includes both lawyers and non-lawyer professionals who are leaders in counseling clients in developing and implementing strategies to achieve optimal coding, coverage, and reimbursement for healthcare products and services. We offer a special focus on counseling clients on Medicare coverage, including Part B and Part D coverage issues, as well as Medicaid, VA, and DOD matters. Our experience includes initiatives relating to the payment rules for all sites of care, product coding, coverage with evidence development, disease management, and CMS interactions with the FDA, AHRQ, NIH, and private payers.
We routinely assist clients in healthcare policy and legislative matters, tracking virtually every significant development that could have an impact on payment for our clients’ products and services, including developing federal and state laws related to drug pricing, coverage policies and procedures, and competitive bidding requirements.
We have also helped numerous clients comply with the privacy, security, and electronic transactions regulations implementing the Health Insurance Portability and Accountability Act (HIPAA). These clients include both HIPAA “covered entities” (e.g., health plans) and non-covered entities, including business associates of covered entities (e.g., information technology and service providers) and others that are affected by the regulations’ restrictions.