Tag Archives | DMAS

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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Billy Tunner

Legal Defense in DMAS Home Health Audits

By on October 22, 2013

What would we do without home health care providers?  They keep “grandma” out of the nursing home by providing 24/7 assistance with the activities of daily living.  They care for our disabled loved ones so that they may remain comfortably and safely at home. Those home health agencies that cater to Medicaid recipients work endless […]

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