Abrams Fensterman, LLP is proud to announce that Alyssa A. Friedman, Partner and Chair of the firm’s Health Care Fraud and White Collar Criminal Defense Practice Groups, was extensively quoted in McKnight’s Long-Term Care News regarding the U.S. Office of Inspector General’s (OIG) newly launched PDPM audits — a development with significant implications for skilled nursing facilities nationwide.
The article, “OIG launches PDPM audits and wants first nursing home it reviewed to repay $31M,” highlights the OIG’s first completed audit under the Patient Driven Payment Model (PDPM) and the sweeping recommended overpayment tied to that review. Speaking to McKnight’s, Friedman raised critical concerns about both the accuracy and methodology of the OIG’s analysis.
“When the Bronx was among the hardest-hit communities in the country, Pinnacle admitted high-acuity residents and devoted extraordinary resources to protecting them,” Friedman told McKnight’s. We are proud that our COVID-related outcomes compared favorably to other facilities, deeply concerned about the competency of the reviewers engaged by the OIG to conduct this review and that the OIG has chosen such an overly technical PDPM lens despite established medical necessity for Medicare skilled services.” – Alyssa Friedman
With a distinguished career spanning senior investigative roles at Healthfirst, the New York State Attorney General’s Medicaid Fraud Control Unit, and the Bronx District Attorney’s Office, Friedman brings unmatched insight into complex government audits, investigations, enforcement actions, and medical necessity disputes. Her practice represents health care providers — including skilled nursing facilities, long-term care organizations, and physicians — in high-stakes regulatory and criminal matters.
As PDPM enforcement intensifies and government scrutiny of care decisions continues to rise, Abrams Fensterman’s Health Care team remains a trusted resource for providers navigating:
- OIG, DOJ, and CMS audits
- PDPM classification and medical necessity challenges
- Medicare and Medicaid overpayment disputes
- Fraud, waste, and abuse investigations
- Regulatory compliance and risk mitigation
Our firm is proud to stand beside healthcare organizations dedicated to delivering quality care under extraordinary circumstances.
Read the full article in McKnight’s Long-Term Care News here.
Contact Our Law Firm
For more information about our Health Care Fraud & White Collar Criminal Defense Practice Group, please contact Alyssa A. Friedman, Esq. at Abrams Fensterman, LLP at (718) 215-5300, [email protected], or visit www.abramslaw.com
