Appealing Medicare, Medicaid and PBM decisions through every administrative level
Challenging adverse audit findings, revocations and licensing determinations
Protecting reimbursement, enrollment and network access while appeals are pending
Representing providers in administrative hearings and court review
When a healthcare provider receives an adverse determination, the appeal is often the last meaningful opportunity to protect reimbursement, preserve participation in government programs, and avoid long-term regulatory consequences.
MDRXLAW represents healthcare providers in administrative appeals involving Medicare, Medicaid, commercial payors, pharmacy benefit managers, licensing agencies, and regulatory authorities nationwide.
Our attorneys have extensive experience challenging:
Medicare and Medicaid overpayment determinations
Extrapolation methodologies
PBM audit findings
Pharmacy network terminations
Prepayment review determinations
Provider enrollment revocations
Coverage denials
Administrative sanctions
Licensing and disciplinary determinations
Agency hearing decisions
Judicial review of final administrative decisions where appropriate
We don't simply respond to audit findings—we attack the legal and factual foundation of the decision.
