Leech Tishman offers comprehensive Medicaid compliance advice and representation, including defense of audits, investigations, and enforcement defense. Leech Tishman counsels healthcare providers nationwide on the complex regulatory, reimbursement, and enforcement obligations associated with participation in Medicaid programs. Medicaid’s structure—layering federal requirements, state-specific rules, and managed care oversight—creates unique compliance and enforcement risk for providers across all sectors. Our attorneys help clients navigate this complexity while maintaining compliant operations and stable reimbursement.
Medicaid Compliance & Participation
We advise providers on:
- Medicaid enrollment, credentialing, and revalidation
- Cost-reporting compliance
- Coverage, eligibility, and payment methodologies
- Managed care contracting and oversight
- State-specific billing, documentation, and utilization requirements
- Program integrity and compliance obligations
We develop and implement Medicaid-focused compliance programs and audit-readiness strategies tailored to state-specific enforcement priorities.
Audits, Recoupments & Enforcement
Leech Tishman regularly represents providers in:
- State Medicaid agency audits
- Managed care organization (MCO) audits and payment disputes
- Repayment and recoupment demands
- Administrative appeals and hearings
- Enforcement actions alleging program violations
We handle disputes involving eligibility determinations, utilization review findings, payment adjustments, and coordination-of-benefits issues, including matters where Medicaid operates as payer of last resort.
