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Health Law Administrative Defense

Whatever your particular administrative-law needs, we would like to discuss your case with you in order to learn more about how we may be able to help you.

  • Texas Medical Board
  • Texas Board of Dental Examiners
  • Texas Board of Nurse Examiners
  • Board of Law Examiners
  • Texas State Board of Pharmacy
  • Texas State Board of Veterinary Medical Examiners
  • Texas State Board of Psychologists
  • Other Occupational Licensing Agencies
  • Texas Department of Insurance
  • Texas Department of Health
  • Texas Department of Human Resources
  • Department of Health and Human Services –IG Exclusions
  • Drug Enforcement Administration

We have represented professionals in administrative investigations and administrative hearings at both the state and federal level in the following areas

  • Compliance with federal and state laws and regulations, including Medicare, Medicaid, and HIPAA
  • Medicare and Medicaid disputes
  • Administrative hearings (formal hearings or informal hearings)
  • Defense in civil suits for negligence

If you know you are being investigated for potential Medicare or Medicaid fraudulent activity, we will provide the strategic, aggressive defense necessary to protect your interests or career. If The Office of Inspector General (OIG) and Attorney General’s Office (AG) contact you, consider legal representation. You can innocently allow OIG or AG office to obtain admissions that may lead to investigations and severe consequences, including penalties such as fines, exclusion from Medicaid and Medicare, and other career-shifting effects.

Medicaid fraud has become an alarming issue in the United States. Medicaid has identified certain billing procedures that may indicate cases of fraud. If a health care provider engages in these practices, Medicare and Medicaid can flag them and make inquiries into their actions. Few doctors commit fraud deliberately. However, many of the mistakes arise from the complexity that surrounds hospital billing systems. Small issues can easily be detected in the audits, and these can have dire consequences on the health care providers. If Medicaid suspects you of fraudulent activities or an improper billing system, they are obligated to make an inquiry. The inquiry begins by requesting certain documentation. The audit begins when something in your billing or coding systems is flagged. Once Medicaid looks into the documents and records you have submitted, they send a letter announcing an audit. Once the documents received have been submitted, the Medicaid auditors will determine whether further investigation is necessary.