Services
Reimbursement and Consulting Services
- Analysis of hospital inpatient and outpatient Medicaid rates
- Medicare disproportionate share reviews
- Development/implementation of reimbursement strategies under the Federal Upper Payment Limit Program
- Development of reimbursement models for Medicaid disproportionate share funds
- Rate analysis for nursing homes and other institutional providers
- Revenue maximization reviews
- Managed care rate reviews
- Detailed claims reviews for compliance with Medicaid billing requirements
- Fiscal impact analysis of legislative proposals
- Responses to request for proposals or Invitations to Negotiate
- Litigation support
Regulatory and Policy Related Services
- State and Federal regulatory and reimbursement policies
- Legislative health care strategic planning
- Development of state plan changes for submission to the Centers for Medicare and Medicaid
- Review and design of health plan anti-fraud and abuse measures