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Medicare Certification, Compliance & Enforcement Defense

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For many health care organizations securing – and maintaining – a Medicare provider agreement is essential to staying in business and providing care to the community. This involves not only initial certification, but being ready for scrutiny through regulatory surveys and responding to allegations of noncompliance.

ArentFox Schiff’s seasoned team of experts in Medicare certification, compliance and enforcement defense are ready to help. Our team includes attorneys with past clinical experience and executive-level experience who have a keen understanding of the operational issues relevant to compliance with Medicare standards.

What We Do

  • We assist clients in becoming Medicare-certified, including interfacing with regulators to solve problems and resolve bottlenecks. We successfully worked with regulators to get stalled processes moving, facilitating timely certification.
  • With our significant experience working with the Medicare Conditions of Participation and Conditions for Coverage, we assist a wide variety of provider clients in attaining and maintaining compliance. This includes advising on mechanisms to maintain compliance, successfully navigate regulatory surveys, and avoid deficiencies from CMS.
  • We are expert at responding to CMS Statements of Deficiencies. We regularly work with clients to advise on or prepare comprehensive – and achievable – Plans of Correction.  We work with providers throughout the correction process, from reviewing deficiencies with the client team, assisting in formulating corrections to meet regulatory compliance, and writing Plans of Correction that are approved by CMS.  
  • When compliance deficiencies have resulted in CMS termination actions against our provider clients, we have brought such actions to a successful conclusion. We engage at the beginning of the action, adroitly navigate administrative law processes, strongly advocate for our client, and carry through to resolution. We are there every step of the way.