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Which attorney is correct?

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micltrnd

Junior Member
What is the name of your state?Florida
Years ago, I sold my practice and retired. I was a Physical Therapist, and owned a Comprehensive Outpatient Rehabilitation Facility (CORF). This is a very specialized area of the law as it involves Part A (not B) Medicare. Not many attorneys specialize in this area of the law. The sales agreement was a 100% stock purchase agreement for an S type corp. The Part A Medicare provider number was included, as it should be in the sales agreement.
I have just received a notice from a collection agency that for 2 of the years I owned this CORF, Medicare claims overpayments were made to me. The purchasers of this CORF, later went down for fraud charges, but never disclosed the demand letters that were sent to the CORF. The collection agency is giving me the "opportunity" to "voluntarily" remit payments due, before they turn it over to the U.S. Justice Dept. for "nonvoluntary payment".
My attorney said that I am in the clear...S type corp. veil of separation of business and personal. All assets/liabilites post sale date are incurred by the new owners. Medicare letters came after the sales date, owners never forwarded them back to Medicare or to me.
I called another attorney, and he said I owe the money. No S type corp. veil on federal funds through Medicare. He said the U.S. Justice Dept. can lein my property, etc.
Thus the debate.
I will be contacting other attorneys in the A.M., but wanted to run this by the forum in the meantime. Anyone out there have any knowledge on highly specialized area of law?
Thx
 


BlondiePB

Senior Member
I understand Medicare billing both parts A & B. Medicare Part A is for hospitalization, qualified Nursing Home stays (up to 100 days), and Hospice. Your patients would have had to be sent to you from their covered Medicare A providers, from the hospital, the nursing home, or from Hospice. You would have to bill your services to the hospital, the nursing home, or Hospice, and they would submit your claim to Medicare A. Then, the hospital, nursing home, or Hospice would send you your money for the services. That's how it works for Medicare Part A.
 

micltrnd

Junior Member
BlondieBP You are correct, but....

Hi,
Yes, all the things you said about Part A are correct except...a CORF has it's own provider number. Therefore, patients need no qualifying stay anywhere to receive CORF's services. CORF's bill directly to the intermediary, which in Florida it was BC/BS, then later First Coast Options Inc. won the contract.
My question has to do with accountability of the claimed overpayments, and the 2 conflicting answers that I received from 2 different attorneys. I thank you for your response, and tomorrow A.M. I will be trying to track down more lawyers with Part A Medicare experience. There are very, very few of them who have this knowledge base, which is why I am taking a shot here also. Can't hurt.
 

BlondiePB

Senior Member
micltrnd said:
Hi,
Yes, all the things you said about Part A are correct except...a CORF has it's own provider number. Therefore, patients need no qualifying stay anywhere to receive CORF's services. CORF's bill directly to the intermediary, which in Florida it was BC/BS, then later First Coast Options Inc. won the contract.
My question has to do with accountability of the claimed overpayments, and the 2 conflicting answers that I received from 2 different attorneys. I thank you for your response, and tomorrow A.M. I will be trying to track down more lawyers with Part A Medicare experience. There are very, very few of them who have this knowledge base, which is why I am taking a shot here also. Can't hurt.
All other services needed to be billed under Medicare Part B. Because they were not, Medicare Part A will take back the money from the provider. Refile the claims under Medicare Part B using your provider number.
 

micltrnd

Junior Member
Didn't intend to get into a debate....

I really didn't intend to begin a debate about Part A vs. Part B Medicare. That isn't even the issue to my original post. The debate would be about which attorney gave me the correct advice. Doesn't matter. I have the A.M. to make my phone calls, just thought I would try this too.
I will leave you with a suggestion. Do a search for CORF, read up about it, then you will realize why a facility with a Part A Medicare provider number, reimbursed by the lower of costs or charges, CANNOT ever-ever bill Part B.
(Part B is reserved for PTIP-Physical Therapist Independent Practice), which is a totally different reimbursement system.
Thx!
 

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