Medicaid / Medicare

Medicaid and Medicare enrollment in good standing and in compliance with State and Federal regulations are very important privileges. These privileges are business essentials for pharmacies and for pharmacists’ employment. For physicians, dentists and all health professionals, these privileges are essential to the ability to fully serve the community and to submit claims, order tests and write prescriptions for Medicaid and Medicare patients, as well as for hospital and group practice privileges and employment.

Jacobson Goldberg & Kulb LLP has extensive experience in representing clients in all aspects of Medicaid and Medicare law, including:

  • Applications for enrollment of pharmacies and health professionals in the Medicaid Program, Medicare Program and Medicaid managed care entities.
  • Reinstatement of pharmacies, pharmacists, physicians, dentists and all health professionals and entities excluded or disqualified by the NYS Office of the Medicaid Inspector General (OMIG) and United States Department of Health and Human Services (Medicare).
  • Pre-screening of OPD/OPMC determinations and criminal convictions with OMIG and Medicare.
  • Investigations, audits, repayment demands and exclusions by the OMIG and Medicare from initial contact through final determination.
  • Criminal defense of all Medicaid and Medicare matters with the NYS Medicaid Fraud Control Unit, the United States Attorney’s Office, and all state and federal prosecutions.
  • Compliance/fraud detection and prevention programs for pharmacies and health professionals and entities to meet Medicaid and Medicare requirements.

It has consistently been our experience that the best outcomes are achieved by engaging experienced counsel from the outset of any Medicaid or Medicare audit, investigation or criminal matter and in Medicaid and Medicare enrollment matters. Please contact Jeffrey Granat at 516-222-2330 or [email protected] for further information, consultation or representation on any of the above matters.