Medicare Reimbursement Legal Services

The Vendor is required to provide advice and consult with agency officials and staff on medicare reimbursement issues and represent agency in legal proceedings, when necessary, to ensure agency receives the appropriate medicare reimbursement authorized in federal statute and/or regulation.
- Services include:
•    Maintain extensive subject matter expertise on medicare reimbursement methodologies, regulations and cost reporting
•    Advise university on changes to medicare reimbursement, regulations and cost reporting
•    Recommend strategies to improve medicare reimbursement for healthcare services university provides to medicare patients
•    Answer questions and consult with university officials and staff on medicare reimbursement methodologies, regulations and cost reporting
•    Advise and consult with university officials and staff on best responses available to university when medicare reimbursement methodologies, regulations and cost reporting changes
•    Assist in the drafting of public comments on proposed changes in reimbursement methodology, regulation or cost reporting that negatively impact university 
•    Advise university officials and staff during the preparation of the annual medicare cost report
•    Advise university officials and staff on protesting amounts when filing a medicare cost report
•    Advise university on medicare reimbursement opportunities for direct and indirect graduate medical education for existing and potentially new programs
•    Coordinate with officials at other hospitals and their legal teams which may be a part of joint legal proceedings
•    Draft legal briefs and file them with the appropriate court or administrative entity.
•    Represent university in legal proceedings in court, the department, or any other body that holds jurisdiction over medicare reimbursement/payment decisions.
•    Meet with CMS or mac officials, when necessary, to discuss problematic interpretations of medicare payment methodology and/or regulation
•    Provide general consulting and other assistance to university officials and staff to respond to unexpected situations that arise related to medicare payment methodologies, regulations and cost reporting
•    Advise and consult with university officials and staff on an appropriate strategy for approaching medicare payment methodologies, regulations and cost reporting
•    Provide necessary ongoing support for any medicare payment methodology, regulation or cost reporting issue that university confronts.

- Contract Period/Term: 3 years
- Questions/Inquires Deadline: September 15, 2025