Nichols Weitzner Thomas LLP (“NWT”) associate, Leah Leibow, JD, MPH, secured a favorable opinion from a Florida administrative law judge this week after a multi-level appeal to justify the client’s use of an amniotic allograft membrane used in a wound care practice. Leah successfully argued that these products were medically necessary, reasonably applied, and supported by the scientific community.
Healthcare providers nationwide are facing a surge in audits and recoupments for their applications of Human Cellular and/or Tissue-Based Products (“HCTPs”) and other similar skin substitute products. Seeing the trend in Medicare action, Leah sought out additional training and became a Certified Outpatient Clinical Appeals Specialist through the American Institute of Healthcare Compliance, Inc., earlier this year. The administrative appeals process can be arduous and confusing. Fortunately, the skilled team at NWT is experienced in navigating the complexities of claim denials, recoupments, and audits. We provide strategic, results-driven legal representation to protect your practice’s financial health. If you or your practice is going through a claim denial appeal, needs recoupment and overpayment defense, or wants to develop proactive compliance strategies, our team is ready to assist.
