2933 North Front StreetHarrisburg, PA 17110
(717) 233-4101
info@capozziassociates.com
FrontHealth Care Practice
Business Law Practice
Labor Law Practice
General Law Practice
Our Newsletter
Online Resources
Calendar of Events
About Our Firm
Staff Biographies
Questions and Answers
Check out our newsletter for important information on the industry. Click Here.
Click above for more information on each specific area
REIMBURSEMENTSURVEY AND ENFORCEMENT
CONTINUING CARE RETIREMENT COMMUNITIES
The healthcare industry is heavily regulated; and, we recognize the need of providers to respond promptly, effectively, and efficiently to regulatory requirements and changes. Our attorneys and staff have extensive experience in regulatory matters; and, we are committed to analyzing the rapidly changing regulatory environment and keeping our clients advised of regulatory changes affecting their operations. We are frequent lecturers at educational seminars on statutory and regulatory changes sponsored by healthcare trade associations and professional groups, and also participate in continuing education programs for healthcare professionals and attorneys on health law matters. Our firm also conducts its own seminars which are approved for continuing education credits through the National Continuing Education Review Service of the National Association of Boards of Examiners for Nursing Home Administrators. Our Healthcare Practice includes the following special areas:
Click below for more information on each specific area
MEDICAID AND MEDICARE REIMBURSEMENT
Our attorneys have successfully litigated and resolved Medicare and Medicaid reimbursement appeals. Our Firm has handled over 1,000 appeals brought by providers to increase Medicare and Medicaid reimbursement, including litigation before federal courts, the Commonwealth and Supreme Courts of Pennsylvania. Capozzi and Associates P.C. has also handled numerous administrative appeals and regulatory matters in other states. While budgetary cuts at the State and Federal levels have resulted in efforts to reduce reimbursement to providers, our goal is to "level the playing field" and obtain payments for costs, care and services to which our clients are legally entitled. Mr. Capozzi was appointed to serve on the Advisory Committee established to provide assistance and guidance to the Pennsylvania Department of Public Welfare in the development, modification, and continuing review of regulations for Pennsylvania's new Medicaid provider appeals process established by Act 142-2002. Our Firm also provides comments and suggested changes to proposed Federal and State regulations affecting our clients' Medicare and Medicaid reimbursement, as well as petitions on behalf of our clients for exceptions and waivers of regulatory limits permitted by law.
Our attorneys are familiar with the requirements for participation in Federal and State healthcare programs and assist our clients with obtaining and maintaining required licensures and certifications and meeting compliance standards for those programs. We have assisted providers in developing effective healthcare policies and in responding to both State and Federal regulators. We have worked with our clients to successfully utilize the informal dispute resolution process. We recognize the sound business sense of resolving some survey disputes amicably without relinquishing the merits of the provider's position and while preserving the provider's appeal rights. The broad experience we have gained from assisting providers through the compliance, survey, and enforcement process is available to our clients.
CONTINUING CARE RETIREMENT COMMUNITIES
We recognize that CCRC's, as a hybrid provider of a continuum of services, face legal and regulatory issues not confronted by free-standing, long-term care providers. Our attorneys can help a CCRC develop residency agreements and respond to the legal challenges of CCRCs. We are familiar with the regulatory framework of the Insurance Department and with the regulators. We can assist in resolving the regulatory and structural issues related to developing a CCRC.
Our Firm has acted as special or corporate counsel in numerous transactions, including acquisitions of facilities in bankruptcy. We work to structure transactions to assure Medicare/Medicaid reimbursement and to streamline the regulatory approval process.
Our Firm is counsel for assisted living providers and has been worked closely with provider and government staff on the development of new laws and regulations for assisted living in Pennsylvania. Our Firm is General Counsel for the Pennsylvania Assisted Living Association.
Capozzi and Associates P.C. is committed to aggressively litigating disputes on behalf of its clients. While providing that representation, we remain conscious of the need to compromise where appropriate and when in the best interests of our clients, particularly in view of the uncertainty and cost of lawsuits both in terms of fees and the diversion of our clients' time and resources. Experienced litigators of the Firm counsel clients concerning these matters and assist them in weighing over-all business interests and objectives against the specific issues involved in any judicial proceeding. In matters where our clients have made a business decision to pursue a claim or where they have been forced to defend claims brought against them, our fundamental goal is to provide the best legal representation available.
The Firm's litigators have broad experience in representing clients in matters such as:
Claims relating to the sale, purchase and operation of businesses, including breach of contract, fraud, misrepresentation, breach of warranties and covenants, unfair competition and restrictive covenants;
Representation of owners and businesses in construction industry litigation;
Defending employers in workers' compensation and unemployment compensation matters;
Proceedings before Federal and State regulatory and administrative agencies;
Defense of employers in labor matter, including matters brought before the National Labor Relations Board]
Defense of employers in matters before State and Federal Regulatory agencies as well as State and Federal Courts on discrimination charges such as those based on Title VII of the Civil Rights Act, ADEA, ADA, FMLA and Equal Pay.
We assist our nonprofit clients with obtaining exemptions from Federal and State sales and use tax and to develop compliance guidelines for preserving their tax exempt status. Our Firm is also experienced in representing both nonprofit and for-profit providers in real estate tax assessment appeals in order to obtain exemptions or reductions in their assessments, including the ability to litigate issues through the appeal process where an amicable resolution is impossible.
Capozzi and Associates, P.C. is a leader in health care compliance, particularly in the long-term care field. The Firm began implementing compliance programs for its long-term care clients even before the Department of Health and Human Services' Office of Inspector General issued its voluntary Compliance Guidance for nursing facilities. Today, the Firm's leading edge approach remains intact because of its strong efforts to constantly seek out the newest and best practices in health care compliance, and to assist its clients in implementing those practices in a careful, cost effective manner. This proactive approach to health care compliance has kept Capozzi and Associates, P.C. and its client ahead of the industry in establishing and maintaining effective compliance programs. While compliance traditionally involves billing issues, the Capozzi and Associates P.C. Compliance and Regulatory Affairs Practice Group takes a broad view of corporate compliance and remains available to assist the Firm's clients with compliance issues in practically all areas that a health care entity faces, including Survey and Enforcement, Labor and Employment, Non-profit tax status, Clinical and quality assurance and Admissions. "Conservative Compliance" is the buzzword to describe the Capozzi and Associates P.C. approach to health care compliance. The Firm's focus is to aid its clients in avoiding compliance issues by instituting effective compliance policies, procedures and training. Where the inevitable compliance issues arise, the Firm assists its clients in developing conservative "low risk" solutions that focus on resolving the problem, while preventing the problem from recurring in the future.
Capozzi and Associates P.C. provide a full range of health care compliance services to its client, including:
Review of current compliance
Development of compliance policies and procedures
Assistance in implementing and operating compliance programs
Development and review of compliance audits
Compliance dispute resolution
Compliance Training
Litigation with State and Federal Agencies, including the OIG.
Our Firm provides assistance with general and corporate issues which every business, including healthcare providers, must confront. We have assisted with restructuring some of our clients to better position themselves for the risks and challenges of the changing healthcare system, as well as to participate in joint ventures or to diminish the risk associated with expanding into new service areas. We also provide special assistance to our clients to update existing policies and practices (including employee manuals), and draft admissions agreements and other contracts that meet program and licensure requirements and assist with timely collections and dispute resolution. We also work with our clients on the development of home- and community-based service programs and strategic planning to consider the legal and business aspects of responding to the ever changing healthcare delivery system.
Our Firm has developed a statewide guardianship practice, including fixed fee charges for working with our clients to obtain guardianships to protect residents and assure continuity of their care. Our Firm has developed relationships with guardianship services organizations that serve as guardians for residents who have no other relatives willing to do so or for residents who need an independent guardian. Our Firm also has experience in coordinating guardianship proceedings with Medicaid eligibility determinations to assure continuity of Medicaid payments.
Our Firm provides collection services to our clients. While aggressively pursuing these matters, we remain conscious of the advantages of compromise, particularly in light of the amount of debt outstanding and our client's resources and need for timely payment. Experienced attorneys, familiar with not only debt collection practice laws, but also with the different regulatory and contractual issues that arise in healthcare collections, counsel our clients and help them develop a collection strategy to meet their needs and preferences.
We’ve become aware that many of our clients’ admissions agreements are outdated or don’t protect the financial interests of their facilities. The overall effectiveness of your facility’s or facilities’ accounts receivable is founded upon the strength of your Admission Agreement form. The Admission Agreement is a contract when it is properly executed by all parties. A valid contract provides the nursing facility certain rights under state and federal laws as a creditor and claimant. Thus, business office directors and staff must have a thorough understanding of several key components of the Admission Agreement. I am sure that many of you will agree that most problems related to collecting on a delinquent account stem from weaknesses in a poorly drafted or completed Admission Agreement. We would be happy to consult with you on how to most effectively modify your admissions agreements to ensure your highest potential for success in the event one of your accounts becomes delinquent. We are happy to provide consultation on a flat fee basis or at our usual hourly rates at your option. Please contact Andrew Eisemann, Esq. at (717) 233-4101 or by Email at andrewe@capozziassociates.com for more information.
Our Firm is Pennsylvania defense counsel for an insurance administrator for self-insured providers. We provide insurance defense counsel in nursing facility liability and malpractice cases, as well as other types of liability cases.