Fax: (210) 745-4645
Practice Concentration and Experience:
Lorraine A. Rosado is a Partner at Liles Parker. She defends healthcare providers and suppliers facing overpayment demands and counsels clients nationwide on compliance with healthcare statutes, regulations, and contract matters. She has represented providers in panel qualification and termination matters, as well as Medicare suspension and revocation actions. She has extensive experience working on complex cases involving both Federal and State violations of the False Claims Act, including whistleblower cases. She is skilled in administrative litigation and appeals.
Lorraine has handled claims disputes involving most major healthcare payors, including Medicare, Medicaid, TRICARE, various BlueCross BlueShield entities, and UnitedHealthcare. She is experienced working on large, complex administrative appeals of extrapolated alleged overpayments assessed by Centers for Medicare and Medicaid Services (CMS) contractors, including Unified Program Integrity Contractors (UPICs). She has represented numerous providers and suppliers in Department of Health and Human Services Office of Inspector General (OIG) audits. She has also repeatedly served as an Independent Review Organization (IRO) for providers and suppliers subject to a Corporate Integrity Agreement with OIG. She leverages her legal experience as well as her coding and compliance certifications to help providers and suppliers recognize and achieve coding and billing compliance.
Lorraine has represented the entire spectrum of medical providers and suppliers, including primary care and specialty physicians and physician groups in private practice and hospital employment; dentists; mental health professionals; podiatrists; home health agencies; skilled nursing facilities; hospices; ambulance service providers; physical, occupational, and speech therapists; chiropractors; and durable medical equipment suppliers.
Lorraine received her J.D. from Lewis and Clark Law School in Portland, Oregon, where she received the Global Law Scholar award. She externed in the chambers of a Senior Advocate in New Delhi, India where she gained experience conducting legal research and writing legal memoranda on matters before the Supreme Court of India. She also studied legal matters in China and Austria while in law school. Lorraine attended Union College in Schenectady, New York where she received a B.A. in Political Science, with a minor in German. In her final year, she was the recipient of the Alvin F. Nitchman Prize, a prize awarded to the most promising senior who plans to attend law school.
- Lewis and Clark Law School, Oregon (J.D. 2011)
- Union College, New York (B.A. 2009, magna cum laude, Phi Beta Kappa)
- American Bar Association
- American Health Lawyers Association
- New York State Bar Association (Member of the Health Law Section's Reimbursement, Enforcement & Compliance committee)
- Certified Professional Coder (CPC) (AAPC - magna cum laude)
- Certified Medical Compliance Officer
- Certified Medical Reimbursement Specialist
- Admitted to Practice in New York
- Admitted to Practice in District of Columbia
Articles and Presentations:
- August 10, 2021, “TPE Audits, ADRs, Pre-Payment Reviews, Post-Payment Audits and Suspensions - What's the Big Deal?” (Webinar for the American Medical Billing Association)
- June 2, 2021, “ADRs, Pre-Payment Reviews, Post-Payment Audits and Suspensions – The Impact of Administrative Enforcement Tools on Home Health and Hospice Agencies” (Webinar for the Texas Association for Home Care & Hospice)
- February 5, 2020, "Medicare Provider Enrollment Changes: 100 New Ways to Lose Your Billing Privileges" (Webinar for the Texas Association for Home Care & Hospice)
- December 4, 2019, "What are the Top 10 Steps You Can Take to Improve the Compliance Efforts of Your Home Health or Hospice Agency in 2020?" (Webinar for the Texas Association for Home Care & Hospice)
- February 8, 2019, "OIG’s Renewed Interest in Orthotic Audits and Investigations: What Your DME Company Needs to Know" (Article)
- January 30, 2019, "The Impact of Medicare's Review Choice Demonstration Project on Your Agency" (Webinar for the Texas Association for Home Care & Hospice)
- April 12, 2018, "ZPIC and UPIC Audits: What about post-payment review delays?" (Article)
- January 10, 2018, "Reading the Tea Leaves – What are the Top Ten Risks Your Home Health Agency and / or Hospice will Face in 2018?" (Webinar for the American Medical Billing Association)
- April 5, 2017, "Preventing the Revocation of Your Home Health or Hospice Agency from the Medicare Program - Tips on Avoiding an Adverse Action" (Webinar for the Texas Association for Home Care & Hospice)
- January 20, 2017, "HHS Issues Final Rule to Address Record High Medicare Appeals Backlog" (Article)
- May 4, 2016, "ADRs, Pre-Payment Reviews, Post-Payment Audits and Suspensions - The Impact of these Administrative Enforcement Tools on Home Health and Hospice Agencies" (Webinar for the Texas Association for Home Care & Hospice)
- February 3, 2016, "Face-to-Face – Is Your Home Health Agency at Risk of Audit and Claims Denials?" (Webinar for the Texas Association for Home Care & Hospice)
- December 22, 2015, "DME Audits are Back! Are Your Claims Compliant?" (Article)
- July 23, 2015, "Audit Entities and Mitigating Risks of Audits" (Webinar for the American Medical Billing Association)
- March 6, 2015, "Medicare Overpayment Demands: The Financial Timeline and Options" (Article)
- February 7, 2014, "Novitas Reminds us of the Impending ICD-10 Transition Date: October 1, 2014" (Article)
- February 3, 2014, "OIG Releases its 2014 Work Plan." (Article)
- November 25, 2013, "Medicaid Dental Audits: Medicaid Dentists are Under the Microscope. Are Your Dental Records Complete and Accurate?" (Article)
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