Hogan Marren Obtains Favorable Medicare Coverage Decision for Hospital

Kelly McCloskey Cherf, Laura C. Liu and Nicholas Hudalla successfully represented a client in its appeal of a Medicare contractor’s determination of overpayment involving a beneficiary’s inpatient hospital services, based on the contractor’s finding that the services were not medically reasonable and necessary.  The Medicare Appeals Council (MAC) reversed the Administrative Law Judge’s decision upon finding that the services were medically reasonable and necessary, and granted Medicare coverage for the inpatient hospital services.  The MAC review is the fourth level of appeal for Medicare coverage determinations and is the final administrative review of claims before a party may appeal to the federal district court