Dealing with Medicaid/Medi-Cal Temporary Suspensions in California – Tips Based on Our Firm’s Experience
Josh Urquhart, a fellow health care attorney at Gordon & Rees’ Denver office, wrote an addendum to my blog from Monday. His comments are on-point and worth reading.
You can find his blog here.
He offers several, specific California- and DHCS-specific tips. However, these tips are analogous to all states and all dentists who accept any government-funded insurance, especially Medicaid.
Here is his last paragraph:
“I know that some of this might be frightening. My first thought after putting pen to paper on this post was to that scene in Empire Strikes Back, when Luke tells Yoda he isn’t afraid, and Yoda tells him ominously “you will be.” But there is a reason for my sturm und drang. As Knicole says, state Medicaid agencies have a good bit of leverage in these overpayment and fraud and abuse investigations, and in my opinion, DHCS falls towards the very top end of that list. This isn’t a time for providers to put their heads in the sand and figure that they’ll deal with any problems with DHCS later down the line if and when something happens. By that point, it very well might be too late – or at the very least, the providers will have missed the best chance (or even the second best chance) to prevent or resolve any problems cheaply and quickly.”
I have to say…it is so nice being a part of a firm with such an amazing wealth of knowledge about health care…and across the entire nation!! At GR, I am now part of a “deep bench” of experienced health care attorneys. (Sorry to toot our horn, but it is really nice!!)
Plus, I learned something new from Josh’s blog. Who knew that “sturm und drang” is an actual phrase and not a sad oversight of spellcheck?? I started to let Josh know of the misspelled phrase until I googled it. Maybe I will try these words on Words with Friends.
Posted on May 28, 2015, in "Single State Agency", Accountability, Administrative Remedies, Alleged Overpayment, Appeal Deadlines, Appeal Rights, Audits, California Medicaid, Dental Medicaid Providers, Dentistry Services, Health Care Providers and Services, Innocent Until Proven Guilty, Lawsuit, Legal Analysis, Legal Remedies for Medicaid Providers, Medicaid, Medicaid Appeals, Medicaid Attorney, Medicaid Providers, Medicaid Services, NC, North Carolina and tagged Audit, California, California Medicaid, Denti-Cal, Dentists who accept Medicaid, DHCS, fellow health care attorney, Gordon & Rees, GORDON & REES LLP, Health care, Health Care Attorney, Health care provider, Josh Urquhart, Medi-Cal, Medicaid, Medicaid Attorney; Medicaid Lawyer; Medicare Attorney Medicare Lawyer, Medicaid Audits, Medicaid Dentists, Medicaid Pediatric Dental Services, NC Medicaid, OIG, OIG audit, state Medicaid agencies, sturm und drang. Bookmark the permalink. 1 Comment.