Author Archive | Michael Matheson

Michael Matheson

Federal District Court Finds General Allegations of Fraud, Duress, and Overreaching Insufficient to Invalidate Contract Dispute Resolution Provisions

By on July 10, 2014

Dispute resolution provisions, such as forum-selection clauses, arbitration clauses, and choice-of-law clauses, are commonly included in modern business and employment contracts.   A recent opinion in Zaklit v. Global Linguist Solutions, LLC[1] from the United States District Court in Alexandria, Virginia addresses a novel issue under Virginia law regarding the validity of these provisions; namely, whether […]

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Michael Matheson

Medicaid Information System Glitch Surprises Provider with $367k Retraction

By on June 25, 2014

Yesterday the Court of Appeals of Virginia released its opinion in LifeCare Medical Transports, Inc. v. DMAS,[1] a case involving a retraction of over $367,000. LifeCare Medical Transports, Inc. (“LifeCare”) provides advanced life support transportation services. Historically, many of LifeCare’s care recipients were dually eligible for benefits from both federal Medicare and state Medicaid. In […]

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Michael Matheson

“Abysmal” Documentation of Services Deemed a Material Breach of the Provider Agreement

By on April 8, 2014

We have previously discussed a line of Virginia case decisions holding that less-than-perfect compliance with the Department of Medical Assistance Services regulations does not always justify a retraction of payments.  Rather, Virginia courts have held that ordinary contract principles govern disputes between the Department and a provider.  Accordingly, a breach of the Provider Agreement does […]

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Michael Matheson

Less-than-Perfect Compliance with DMAS Regulations Does Not Always Justify a Retraction of Payment

By on November 18, 2013

As providers work tirelessly to furnish essential health care services to the elderly, disabled and infirm, they must navigate the DMAS Provider Agreement as well as labyrinthine federal and state regulations to ensure that services are documented in a manner acceptable to the Department.  Let’s face it: none of us are perfect.  When a provider […]

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