Legal Advocacy FAQs

What is the Center for Health Care Law?
The Center for Health Care Law is a nonprofit, public interest law firm, established by NAHC in January 1987. William A. Dombi, an attorney with more than 27 years of experience challenging arbitrary governmental actions, has acted as director since its inception. Denise Bonn, an attorney with 18 years of experience in health law, joined the Center as Deputy Director in 2005.

The purpose of the law firm is to help protect the rights of the elderly, disabled, handicapped, and chronically ill who require health care services. The Center intervenes on behalf of such persons, filing lawsuits against Medicare, Medicaid, health maintenance organizations, and private insurance companies when necessary to protect their vital interests. Numerous other public interest law firms assist the Center in its efforts to address important health care law issues.

The Center handles most of the litigation that NAHC feels must be brought on behalf of the membership. This approach, unique among health care associations, provides a valuable tool to NAHC and its members, who may be faced with arbitrary governmental action. The success of this venture was highlighted in the landmark Medicare class action lawsuit, Duggan v. Bowen, where the home care industry challenged Medicare's dismantling of the home health benefit. As a result of the litigation, the entire Medicare home care benefit was rewritten.

While concentrating on matters that significantly affect the home health industry and patients, the Center also is available to help individual NAHC members who require expert, specialized legal assistance. NAHC member agencies can readily access the Center's skilled legal services from attorneys specializing in home care law on the range of issues affecting their business. Since 1987, the Center has assisted thousands of individual agencies with legal problems related to third-party payments, licensure, risk management, employment law, and business planning. Many of these legal needs can be satisfied by the Center without charge to NAHC members or with a modest reduced rate, depending upon the extent of the issue and the necessary effort by the Center.

Overall, the Center has provided extensive and invaluable services to NAHC and its members through litigation, legal advice and representation for individual members, and legal input on legislative and regulatory issues affecting the home care industry.

Here are some examples of questions members ask the Center for Health Care Law:

• How can I protect my agency and the patient whenever we must discharge while the patient still needs skilled care? We do not want to be in an abandonment situation.
  
  
• Medicare claims it overpaid me. How can I get an extended repayment plan and improve my cash flow?
  
  
• Coverage denials, sampling audits, cost report disallowances - there are steps to appealing Medicare claims and cost reports. Where do I start?
  
  
• How can my agency pay its medical director, who also refers to the agency, and not violate the anti-kickback rules? What if we also rent office space in a building this person owns?
  
  
• What risks does the agency face if we pay staff by the visit? Can we mix per visit pay and hourly pay to the same employee?
  
  
• Medicare auditors are finding that some of my costs are nonallowable, like advertising, community outreach, and owner/executive compensation. What is the policy behind these costs? How can we challenge the auditors and get the costs recognized?
  
  
• We want to establish a branch office. What are the rules that always seem to change? The state surveyor is claiming a COP violation. Is she right? What are the regulations and interpretative guidelines?