Reimbursement and Consulting Services

• Evaluation of participation in a Directed Payment Program (DPP), Indirect Medical Education (IME) and Graduate Medical Education (GME) programs
• 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