Mark D.
Polston

"Represented over 200 hospitals in a successful lawsuit challenging CMS's decision to cut inpatient Medicare hospital rates to offset the financial impact of the so-called Two Midnight rule, leading to a reversal of the policy by CMS and an influx of approximately $660 million in additional Medicare reimbursement to the nation's acute care hospitals."

"Won an $18 million arbitration award for a national healthcare company involving breach of contract and fraud claims against sellers of a Medicare-reimbursed hospice."

"Spearheaded the RAC Coalition, a group of the nation's leading hospitals which successfully lobbied for reform of the Medicare Recovery Audit Contractor program."

"Leading the Stark Reform Coalition, a consortium of hospitals seeking reform of the Stark Physician Self Referral Law."

"Representing an academic medical center in a False Claims Act investigation involving allegations of violations of the Medicare provider-based facility rule."

"Representing Community Health Systems in numerous cost report reimbursement appeals before the Provider Reimbursement Review Board and in federal court."

"Representing the Florida Hospital Association and several Florida hospitals in multi-million dollar group appeal challenge to CMS policy excluding Low Income Pool Section 1115 expansion waiver days from the Medicare DSH payment calculation."

"Counseled major Mid-Western hospital chain on reorganization of its Medicare Graduate Medical Education programs, including seeking rural re-designation of certain hospitals in order to maximize FTE 'cap space' and take advantage of relaxed rules for creation of 'new' medical education programs, all of which resulted in millions of dollars of additional Medicare reimbursement."

"Successfully assisted academic medical center in seeking 'on-campus' status from CMS for provider-based facility located more than 250 yards from campus, resulting in millions of dollars of additional Medicare reimbursement."

"Counseled numerous providers on the 60-day overpayment rule, including advising a hospice provider in identifying and returning a $10 million overpayment refund to the Medicare program."

"Representing 30 hospitals in a multi-million dollar challenge to CMS regulation which arbitrarily penalizes teaching hospitals for training medical fellows above their 'FTE cap.'"