Medicare Provider’s Wrongful Revocation Reversed

Posted on Firm News by author

In a case involving a large physician practice represented by the Florida health law firm of Nicholson & Eastin, LLP, CMS reversed its decision to revoke the physician practice’s Medicare billing privileges, and immediately reinstated the billing privileges retroactive to the date of revocation.

After deciding to cease operating its on-site lab operations, our Florida Medicare provider voluntarily relinquished its CLIA certification.  Almost two years later, the Medicare contractor notified the provider of its decision to revoke the practice’s Medicare billing privileges for alleged noncompliance, specifically failing to renew its “medical license.”  Unable to get a favorable response from First Coast Service Options, the Medicare Contractor for Florida, the medical practice engaged Nicholson & Eastin, LLP to assist. The firm contacted First Coast Service Options, as well as CMS’ Provider Enrollment personnel, and explained that the provider was still properly licensed and that the license relinquishment related solely to a CLIA certification.  After attorneys from Nicholson & Eastin contacted First Coast and CMS, they immediately reversed the revocation decision retroactive to the date of the erroneous revocation.

The law firm of Nicholson & Eastin, LLP, regularly represents Medicare providers and suppliers whose Medicare billing privileges have been suspended or revoked.  The firm also represents Medicare providers with audits and prepayment reviews. If you have a Medicare enrollment issue, audit or prepayment review, please do not hesitate to contact us to evaluate your case.