Thompson Coburn partner Mackenzie Wallace co-authored the new American Bar Association publication A Practical Guide to Reimbursement in Managed Care, which provides a detailed account of Medicare reimbursement and payment approaches used across provider types. The book also includes a practical discussion of commercial payer contracting and payment strategies. It concludes with an analysis of the legal issues that arrive in payer-provider disputes, including the most common issues and case examples. The publication’s co-authors include Joanna Younts, Steven Hamilton, and Franklin Stevens.
“One of the goals of managed care is to improve the quality of and access to care for patients, but the intricacies of the processes related to the delivery and reimbursement of healthcare services can result in complex administrative procedures for providers,” the authors concluded in the guide. “In turn, these complexities can trigger underpayments and claim denials that can impact providers’ ability to provide access to high-quality patient care. Ensuring fair and accurate reimbursement to providers is important to ensure that quality and access are not undermined.”
Mackenzie is an experienced trial attorney representing health care entities, businesses, and directors in high-stakes litigation. She represents hospitals and health care providers in coverage and reimbursement disputes; fraud and civil RICO claims; Texas Prompt Pay Act, qui tam, and False Claims Act litigation; and matters relating to the violation of federal and state anti-kickback provisions and Stark laws.
Click here to read more and to order the book.
Although we would like to hear from you, we cannot represent you until we know that doing so will not create a conflict of interest. Also, we cannot treat unsolicited information as confidential. Accordingly, please do not send us any information about any matter that may involve you until you receive a written statement from us that we represent you (an ‘engagement letter’).
By clicking the ‘ACCEPT’ button, you agree that we may review any information you transmit to us. You recognize that our review of your information, even if you submitted it in a good faith effort to retain us, and, further, even if you consider it confidential, does not preclude us from representing another client directly adverse to you, even in a matter where that information could and will be used against you. Please click the ‘ACCEPT’ button if you understand and accept the foregoing statement and wish to proceed.