Laith Quasem
Associate Attorney
Professional Licensing & Regulatory Affairs, Healthcare Compliance, Federal Criminal Defense
Seattle Office (Satellite)
Washington
Phone: (877) 234-5911
When a Michigan DME company’s Medicare supplier number was revoked with multiple allegations, our compliance attorneys got it reinstated.
Our healthcare compliance attorneys got a physician’s Medicare enrollment and billing privileges restored, after requests for medical records unknowingly went unheeded.
Providers who does not participate in Medicaid may assume that WA’s Medicaid Termination and Exclusion List doesn’t apply to them …………
Attorney Laith Quasem of Chapman Law Group was recently featured in a Stateline article examining the federal government’s expanding efforts to combat Medicaid fraud across all 50 states.
A Washington State dentist had been placed on the Washington Medicaid Provider Termination and Exclusion List following a prior criminal conviction. The conviction involved financial and tax-related conduct associated with the business operations of his dental practice but it did not concern Medicaid billing, patient care, or participation in any federal or state healthcare program. The dentist had completed his sentence years earlier, maintained his dental license, continued serving his community, and implemented additional financial and compliance safeguards within his practice.
Years after the original Medicaid action, his continued presence on the state exclusion list created an urgent new problem. A private dental payer notified the dentist that his participation in two of its commercial dental networks was being terminated immediately, citing his inclusion on a government sanction, exclusion, or preclusion list. For a solo practitioner whose patient base relied heavily on those networks, the consequences extended far beyond Medicaid, threatening established patient relationships, continuity of care, and the financial stability of his practice. The dentist turned to Chapman Law Group for help.
Our attorneys recognized that the most effective path forward was to address the problem at its source rather than rely solely on the private payer appeal. We pursued both avenues simultaneously, timely appealing the private payer’s network termination while submitting a detailed written request to the Washington State Health Care Authority (HCA) seeking the dentist’s removal from the Provider Termination and Exclusion List.
The submission to HCA was comprehensive. It addressed the history underlying the original exclusion, the dentist’s acceptance of responsibility and rehabilitation, the financial and compliance safeguards implemented within his practice since the underlying conduct, his lengthy and unblemished professional record following the conviction, his ongoing service to underserved communities, and letters of support from professionals familiar with his practice and character.
HCA presented the submission to its Medical and Dental Advisory Committee for review. The Committee ultimately approved the request, and HCA moved to remove the dentist from the Washington Medicaid Provider Termination and Exclusion List.
Following HCA’s approval, our team promptly notified the private dental payer that the dentist was no longer included on the state exclusion list. The payer subsequently rescinded its termination of the dentist’s participation in both commercial dental networks, effective immediately, as the stated basis for the termination no longer applied.
The outcome preserved the dentist’s ability to continue treating patients covered under both networks, protected the stability of his practice, and resolved an exclusion that had followed him for years, not simply by seeking re-enrollment in Apple Health, but by eliminating the underlying condition that had become the basis for adverse action across his private professional relationships.
Laith Quasem
Associate Attorney
Professional Licensing & Regulatory Affairs, Healthcare Compliance, Federal Criminal Defense
Seattle Office (Satellite)
Washington
Phone: (877) 234-5911
This information is a sample of our past results. Prospective clients may not obtain the same or similar results. Every case is different, and each case must be evaluated and handled on its own merits. The circumstances of your case may differ from the results provided. The information provided has not been reviewed or approved by the State Bar.
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Laith Quasem
Associate Attorney
Professional Licensing & Regulatory Affairs, Healthcare Compliance, Federal Criminal Defense
Seattle Office (Satellite)
Washington
Phone: (877) 234-5911
When a Michigan DME company’s Medicare supplier number was revoked with multiple allegations, our compliance attorneys got it reinstated.
Our healthcare compliance attorneys got a physician’s Medicare enrollment and billing privileges restored, after requests for medical records unknowingly went unheeded.
Providers who does not participate in Medicaid may assume that WA’s Medicaid Termination and Exclusion List doesn’t apply to them …………
Attorney Laith Quasem of Chapman Law Group was recently featured in a Stateline article examining the federal government’s expanding efforts to combat Medicaid fraud across all 50 states.
