Focused Medicare Appeals Practice
My Medicare appeals career began in 2006 at the Office of Medicare Hearings and Appeals (OMHA), which began operations in July 2005 after being established under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. I am a former federal attorney with 20 years of combined experience within four components of the U.S. Department of Health and Human Services: OMHA, the Centers for Medicare & Medicaid Services, the Office for Civil Rights, and the Departmental Appeals Board. At the Departmental Appeals Board, I provided authoritative legal advice and staff support for the Medicare Appeals Council's review of Administrative Law Judge decisions.
Approach to Medicare Appeals
My approach is disciplined in method and responsive to change. Since Medicare’s enactment in 1965, “reasonable and necessary” has remained a central standard for determining whether items and services qualify for coverage under § 1862(a)(1)(A) of the Social Security Act. The statutory foundation has endured, but its application continues to evolve as policies are revised, medicine and technology advance, utilization and billing trends emerge, courts clarify legal boundaries, and enforcement priorities shift. I bring consistent rigor to every appeal by remaining current with the legal, policy, clinical, and enforcement developments shaping Medicare practice at the time of review.
Prior federal service does not imply current government affiliation, endorsement, special access, or influence.
Assistance for Medicare Beneficiaries
A beneficiary appeal can affect access to care, personal financial responsibility, or continuation of services. I explain the decision, the next appeal step, the evidence that matters, and the available options. Every Medicare beneficiary receives a reduced fee from my standard provider rate.
Simple Engagement Process
Submit a consultation inquiry. Do not include medical records, Medicare numbers, patient names, or other protected health information.
Within 48 hours, I will respond with any additional information needed, available appointment times, and the consultation fee.
During the consultation, we will discuss the appeal process and the procedural posture, applicable deadlines, and the legal services that may be appropriate.
If we proceed, the written engagement agreement will define the services provided, each party’s responsibilities, the fee arrangement, and the stage or stages of review included in the representation.
No attorney-client relationship or legal-services engagement begins unless conflicts are cleared and both sides accept a written engagement agreement.
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