Procedural Due Process Challenges to Medicare Pre- and Post-Payment Review

Rebekah Plowman and Kara Silverman authored an article published in the April 2019 edition of AHLA’s Health Care Liability and Litigation Practice Group newsletter. In the article “Trends in Challenges to Medicare Payment Disputes: Always Pro-Provider?”, Ms. Plowman and Ms. Silverman discuss the current status of cases where providers have challenged, on procedural due process grounds, the administrative process for Medicare payment disputes that often result in three- to five-year delays in adjudicating claims while providers are faced with almost certain bankruptcy and financial devastation, as well as the potential application of procedural due process rights to providers facing CMS’s imposition of prepayment review.

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