Nelson Hardiman navigates Medi-Cal’s complex regulatory landscape with the fortitude and determination of seasoned healthcare attorneys. We have advised some of the largest hospitals and health systems on cases that involved audits, appeals, allegations of fraud and abuse, reimbursement issues and overpayment disputes. Because of our deep experience and our role as industry leaders, we are uniquely qualified to advise healthcare providers large and small on the challenges and opportunities of participation in the Medi-Cal program.

Our Work Includes:

  • Administrative Proceedings Advised healthcare providers in Medi-Cal administrative appeals and related judicial proceedings.
  • Business/Operational Procedures Modified provider business plans and implemented new policies and procedures to comply with Medi-Cal regulations.
  • California Medical Board Prevailed on a motion for review of Board records, resulting in dismissal of a case against a physician accused of criminal Medi-Cal fraud.
  • Enrollment Successfully appealed denial of Medi-Cal provider enrollment application for medical professionals.
  • Factoring Advise Medi-Cal providers on healthcare factoring to gain access to capital to fund ongoing business.
  • Litigation Overturned wrongful Medi-Cal suspension of medical practitioner based on criminal conviction.
  • Regulatory Compliance Represented university medical center in a petition to overturn a Medi-Cal audit decision by the Department of Health Care Services (DHCS).