Law Office of Deborah Randall
law@deborahrandallconsulting.com
237 9th St. SE
Washington, DC 20003

Review and address reimbursement potential, industry developments, and services' claims denial issues for homecare, hospice and other community-based long term care providers including document requests (ADRs), RAC reviews, claims denial appeals strategy and negotiations with the MACs and central CMS.

Draft, amend, review and/or suggest policies and procedures for home health agencies, hospices, and other community-based health providers to address federal certification or conditions of participation (when present), accreditation, licensure, compliance plan, Red Flag and HIPAA requirements. Address legal issues in telehealth systems/delivery.

Assess risk management and fraud and abuse exposure in alignment of providers with other providers, physicians, and community referral sources. Prepare compliant physician and facility contracts for hospices, home health agencies, private duty and medical device companies.

Perform ''spot-check'' on-site audits of strategic compliance program capability of health care providers. Assess strengths/weaknesses of compliance plans. Guide and counsel Corporate Compliance Officers in health systems, home health agencies, hospices, long term care facilities and other licensed and regulated community providers.

Negotiate for providers with payers, and assist providers in rebating overpayments and/or refunding claims errors discovered in self audits and other analyses of financial and clinical records.

Collaborate with civil and criminal defense counsel to assist providers during whistleblower or suspected investigations by fraud and abuse enforcement agencies.

Expert witness support in arbitration, administrative and judicial proceedings in the fields of homecare and hospice/end-of-life services, telehealth and telemedicine.

Perform expert due diligence work as either specialist advisor to other counsel or consultants, or as project manager, in the acquisitions and sales of homecare, hospice, palliative care, telehealth, long term care and CCRC facilities.

Facilitate regulatory filings and licensure reviews in change of ownerships [CHOWs] and federal requirements. Collaborate with and advise inside counsel and local outside counsel on state and local requirements and filings.