The Nan Gallagher Law Group Wins Six-Figure 3rd Level Medicare Appeal on Behalf of Elated Physician


After a six-year battle with the Centers for Medicare and Medicaid Services (CMS), Ms. Gallagher won a 100% favorable judgment of approximately $600,000, one of the largest awards in podiatry, for a New Jersey podiatrist from Administrative Law Judge P. McAfee. With expert testimony of Dr. Paul Kesselman on this complex 3rd level Medicare appeal, backed by the comprehensive documentation and coding analysis of Dr. Kesselman and Dr. Alan Bass of PARE Coding and Compliance, the ALJ ordered the return of roughly $600,000 overpayment to the podiatrist who had struggled to pay it back to Medicare over five years. 

When asked to comment on the victory, Ms. Gallagher said, “My client sacrificed everything for this fight and never gave up.  Medicare was relentless in demanding that he repay every penny to them plus interest while this meritorious appeal was pending.  The arguments and evidence we presented clearly demonstrated that the CMS auditors and the QIC analysts were outright wrong in their review, standards, and decisions on this matter.  It was a pleasure to elucidate this to the ALJ, and my client and I are grateful to him for listening to us with an open mind.  The day that CMS refunded the nearly $600,000 overpayment back to my client with interest was a momentous event that I will never forget.  It feels good to slay dragons!”

Leave a Reply

Your email address will not be published. Required fields are marked *