NJ Duo Obtains Lift of Payment Suspension

Gregory Miller and Timothy Gonzalez succeeded in getting the Centers for Medicare and Medicaid Services (CMS) to stop suspending payments to the firm’s client, a clinical laboratory.

In 2022, the client had its Medicare and Medicaid billing privileges suspended due to allegations of fraud. The client’s previous counsel failed to defend against these claims, leading to an extended suspension by CMS.

In 2023, Greg and Tim were asked to review and respond to the allegations. They conducted a thorough evaluation of the client’s procedures and claims data and developed an innovative strategy to prove the legitimacy of the client’s work. That strategy centered on a comprehensive written submission and extensive evidence proving that CMS’ fraud allegations were baseless and the suspension unwarranted.

Greg and Tim also targeted their outreach to key individuals at CMS and the Department of Health and Human Services (HHS) to ensure their submission was received and reviewed by decision makers. Despite numerous procedural and bureaucratic challenges, Greg and Tim secured a meeting with critical stakeholders both at CMS and HHS, where they successfully demonstrated the services provided by the client were bona fide, and no fraud occurred.

The client recently received notice that CMS terminated the laboratory’s Medicare and Medicaid suspension