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Medicare & Medicaid Fundamentals


Level: Intermediate
Runtime: 93 minutes
Recorded Date: February 15, 2018
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Agenda

12:00 pm - 1:30 pm
  • Background - Enrollment, Four Parts, Funding, Eligibility
  • Coverage under Parts A, B, C, D
  • Program Administration
  • Payment Systems under Parts A, B, C, D
  • Provider Enrollment
  • Appeals Process
  • Authority
Runtime: 1 hour and 33 minutes
Recorded: February 15, 2018

Description

Healthcare is driven and shaped by the funding available to healthcare providers. Government programs are the primary source of funding, and the impact these programs have on healthcare providers is inescapable.

Join Craig H. Smith and Michelle E. Lin who will distill Medicaid and Medicare, the two main complex government programs, into basic, easy to digest segments.

This program was recorded on February 15th, 2018.

Provided By

American Bar Association
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Panelists

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Craig H. Smith

Partner
Hogan Lovells LLP

Having served as general counsel at one of the nation's largest state Medicaid programs and health care regulatory agencies, Craig Smith is highly qualified to advise health care industry clients across the nation on complex regulatory issues in transactions and disputes.

Craig is board-certified in Health Law by the Florida Bar, and Chambers USA ranks him in the top tier of all health care lawyers in Florida.

After serving as general counsel for Florida's Agency for Health Care Administration, Craig returned to Hogan Lovells to help health care providers, managed care organizations, and private investment firms on Medicare and Medicaid program issues, including federal and state prohibitions against kickbacks, fee-splitting, and patient self-referrals. He also oversees internal investigations for clients and represents them in litigation and arbitration proceedings.

Craig received his JD at The Ohio State University Moritz College of Law in 1996.

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Michelle E. Lin

Prinicpal
Lin & Patel, LLC

Ms. Lin is a founding Principal with Lin and Patel, LLC. Ms. Lin strategically guides health care providers through the continually-changing regulatory environment. She concentrates her practices in several areas including, payor audits, payment issues, compliance with statutes and regulations, including the Anti-Kickback Statute, Stark, physician licensing matters, and the sale and purchase of provider practices. Ms. Lin devotes her practices to legal issues impacting acute providers such as hospitals, post-acute providers including home health care agencies and hospices, physicians and physician groups. Ms. Lin focuses her practice on defending providers against pre and post-payment audits resulting in overpayments, and has successfully defended clients at all levels of the Medicare appeals process and against other auditing agencies. Ms. Lin also regularly counsels providers regarding corporate and employment related matters.

Prior to joining Lin and Patel, LLC, Ms. Lin was General Counsel of a long-term care provider, facilitating it through the purchase of other providers, surveys/corrective action plans, pre and post-payment audits, contract drafting and negotiations, and employment related matters. Ms. Lin also worked as General Counsel for a hospital where she advised on the day to day operations of the hospital, including drafting and negotiating contracts, advising on compliance related matters, reviewing and revising policies and procedures impacting employees and Medical Staff, and managed risk management cases. She was also employed as Corporate Counsel for a physician practice where she most notably helped it secure a favorable appeal of a large Medicare overpayment.

Prior to her recent in-house experience, Ms. Lin worked in private practice in insurance defense litigation.


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