Medicaid-funded Agencies

We assist Medicaid-funded non-profit agencies respond to State actions alleging Medicaid over-billing, fraud, and other compliance issues, as well as State proceedings seeking to revoke their licenses, or force a merger or dissolution. Our breadth of experience allows us to further serve these clients by advising them on general compliance, non-profit, and corporate law matters.

Our Services

Notably, we have been involved in:

• Representing parties in all three mergers of New Hampshire area agencies for the developmentally disabled.
• ​Successfully representing two Medicaid-funded agencies for individuals with mental illness and developmental disabilities opposing the State’s protracted efforts to revoke their licenses and force large Medicaid fraud and overbilling reimbursements.
• Challenging changes to the State’s Medicaid rate-setting methodology for nursing homes resulting in a New Hampshire Supreme Court opinion invalidating these changes and potentially requiring millions of dollars in reimbursement.
• Drafting and obtaining enactment of two “first-in-the-nation” Medicaid related bills creating

1. personal liability for any person who participates in transfers resulting in an asset transfer disqualification under Medicaid or for any fiduciary who negligently fails to promptly complete and pursue a Medicaid application or who refuses to pay the patient liability amount due under Medicaid; and,
2.  the “Special Medicaid Representative” who may be appointed upon the request of a care facility in the event of noncooperation of a patient or resident (or their family members or fiduciaries) to complete and submit an application for Medicaid coverage.

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