Healthcare Litigation and Administrative Proceedings

Healthcare Litigation and Administrative Proceedings

For the past eleven years we have counseled medical groups, healthcare businesses and corporations in the realm of federal and state labor law compliance, corporate compliance and business practices compliance. In that time Mr. Birzon also defended Medicare providers in Medicare and Medicare contractor audits including but not limited to Program Integrity Audits, Zip-C Audits, RAC Audits and all phases of consequential appeal within the jurisdiction of the United States District Courts.

Our firm has worked with medical billing experts, certified coding experts, medical experts and accountants in defending physicians and their professional corporations against claims or allegations of fraud. We have extensive experience in CPT code, ICD-9&10, HCPCS, Local Coverage Determination and Medicare/Medicaid HMO disputes.

For the past twenty-six years, Mr. Birzon represented physicians and medical groups against claims of medical fraud, negligence and unethical practice. He represents clients in both state and federal courts, for the New York State office of professional medical conduct, the New York State Office of Professional Discipline, Center for Medicare and Medicaid Services, Office of Inspector General and the New York State Office of Medicaid Inspector General.

Over the past eleven years, we have defended medical practices in countless state and federal medical fraud and RICO actions commenced by automobile insurers. Within the context of those cases we have been unafraid to vigorously defend those claims resulting in clients meeting standards in reasonable compliance with the New York State’s Business Corporation, Health and Education Laws.

Peter Birzon has overwhelmingly focused on perpetuating and defending the healthcare industry for more than twenty-five years. Peter Birzon & Associates has continued to represent hundreds of health care practices in the past twelve years giving our firm an inherent advantage when dealing with the healthcare practice issues that arise in litigation. Healthcare litigation first and foremost requires a detailed knowledge of the underlying operation of the client's medical practice, a detailed knowledge of the law, its history of application to the health care professions and a deep understanding of the adversary in each and every instance. We see legal defenses, practice operational defenses, substantive medical defenses and standard of care defenses that can evade a litigation department not intimately familiar in the defense of medical practices.

We work with clinical laboratories, ambulance companies and ambulance services in certification and recertification proceedings while counseling our clients in the rare instance of litigation upon receipt of a certification denial.

As experienced healthcare litigators we confront physician shareholder disputes, employee physician disputes, medical malpractice claims, insurance carrier recoupment and recovery claims, no-fault insurance fraud claims, workers compensation insurer fraud claims, bad faith coverage claims, employment claims, sexual assault claims, assault and battery claims, landlord tenant lease breach claims, commercial leasehold eviction proceedings, proceedings commenced by the Drug Enforcement Administration, the New York State Attorney General, the Office of Medicaid Inspector General and the United States Government.

At the administrative level we represent physicians before the New York State Office of Professional Medical Conduct (“OPMC”), The Office of Professional Discipline (“OPD”), and in connection with hospital staff privilege matters, physician fellowship and/or residency program terminations, limitations on hospital privileges, unwarranted insurance carrier credentialing denials, insurance carrier credential terminations, management company disputes, equipment leasing company disputes, entitlement program audits including but not limited to RAC, ZIP-C, PIM, Medicaid and private insurer audits.

As a member of the American Health Lawyer Association, we find appropriate circumstances for use of AHLA mediation and arbitration services when seeking resolution of intra-professional disputes that are best kept private and out of the public court system.

© 2024 Peter Birzon & Associates
400 Jericho Turnpike, Suite 100, Jericho, NY 11753
| Phone: (516) 942-9100

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