Covington advises and represents pharmaceutical manufacturers, device manufacturers, hospitals, health plans, and other health care providers on issues involving reimbursement in the Medicare and Medicaid programs and issues of health information privacy. Our broad practice and deep-rooted understanding of the structure and operations of federal and state reimbursement programs enable us to develop workable solutions to complex problems and to assist our clients in developing strategies that provide a competitive advantage, minimize risk, and optimize opportunities.
Whether we are providing advice, working legislatively, or negotiating with the Centers for Medicare & Medicaid Services (“CMS”), we have the knowledge, skills, and expertise to assist pharmaceutical manufacturers, device manufacturers, and providers in navigating the intricacies of Medicare and Medicaid reimbursement. We regularly advise clients with respect to reimbursement issues pertaining to all aspects of the Medicare program, including the Part D prescription drug benefit. We also advise pharmaceutical manufacturers with respect to their reporting and payment obligations under the Medicaid Drug Rebate program. We have advised hospitals and health plans on intricate federal rules and policy governing such areas as upper payment limits and reimbursement for graduate medical education. In disputes between providers and their Medicare fiscal intermediaries, we have appeared before the HHS Provider Reimbursement Review Board and in court.
Our lawyers bring to the table:
- Government experience;
- Detailed knowledge of relevant laws and regulations;
- Ability to work with regulators and legislators; and
- Understanding of clients’ business models.