Industry: Post Acute Care

PPSV maintains an active and diverse post-acute care practice serving a wide variety of long term care providers and their ancillary service companies.  Our attorneys represent these entities in every aspect of their relationship with government agencies, accrediting bodies, third-party payors, including managed care organizations and insurers, and resident and advocacy groups.  

We assist multi-facility provider corporations of every size; freestanding and hospital-based providers; national, state and local associations; individual providers; and for-profit and not-for-profit facilities, including: 

• Long term acute care hospitals
• Rehabilitation hospitals
• Skilled nursing facilities
• Nursing facilities
• Intermediate care facilities for the mentally disabled
• Home health agencies
• Hospice
• Assisted living and other types of non-institutional care facilities and providers
• Related provider associations  

Our approach to legal services for post-acute care entities is practical and operations-oriented and has included such matters as: 

• Medicare and Medicaid payment issues, including:
  • Reimbursement methodologies
  • Coverage policies and determinations
  • Survey and certification
  • Provider-based criteria
  • Coverage denials and appeals, including Administrative Law Judge and Medicare Appeals Council hearings
  • Recovery Audit Contractor (RAC) audits
  • Reimbursement disputes, including Provider Reimbursement Review Board and Medicare Geographic Classification Review Board cases
  • Medicaid funding (provider taxes and intergovernmental transfers)
  • Eligibility fair hearings
• Fraud and abuse concerns, including audits and investigations
• Compliance programs
• Certificates of need
• Licensure and accreditation
• Provider networking
• Privacy requirements
• Corporate and tax law
• Shaping and responding to changes in statutes or regulations