Thursday, August 16, 2012

Recovery of Medicare Underpayments

When Grady Memorial Hospital was getting less than their fair share of federal funding for Medicare, they turned to Charles Johnson and Paul Vranicar in the Atlanta office of Holland & Knight.   As a result of an intermediary's interpretation of Medicare regulations, Grady had been underpaid by approximately $4 million from 2003-2004.  The Atlanta team quickly pushed two cases that had been pending for years to hearings before the Provider Reimbursement Review Board in Baltimore.  At the last moment before each hearing, the intermediary agreed to reimburse Grady for almost the full amount owed. 

Grady Memorial Hospital is the primary hospital for inner-city and medically indigent populations in DeKalb and Fulton Counties - the two largest counties in the Atlanta metro area. Grady Memorial Hospital serves as the only Level-1 trauma center in metro Atlanta and for 100 miles in all directions. It also serves as one of only two burn units in the state, provides ambulance coverage for the city of the Atlanta, houses the state's Poison Control Center, and serves as a regional referral for high-risk obstetrics and neonatal care.

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