Medical Assistance Consulting

As Pennsylvania’s leading Medical Assistance consulting firm, DeBrunner & Associates uses our unmatched policy expertise to help our clients – hospitals, long-term care providers, home and community based providers, provider associations, biopharmaceutical companies, and others – maximize their Medical Assistance reimbursement.

We do this by understanding all of the intricacies of Pennsylvania’s Medicaid program. We identify and take advantage of waivers, regulations, and other legitimate mechanisms for revenue enhancement and seek opportunities to pursue public policy changes that benefit our clients. We address client issues with the General Assembly, as needed, and help clients identify the state officials with whom they must work to achieve their policy objectives.

We also work on many technical aspects of reimbursement enhancement, including verifying the accuracy of Medicaid disproportionate share, medical education, and tobacco payments; calculating individual hospitals’ Medicaid DSH limits and often helping them with the complex process of restating those upper payment limits – a major step toward increasing reimbursement; and projecting the potential impact of proposed service mix changes on client Medical Assistance revenue. In addition, we model the impact of proposed changes in Medical Assistance reimbursement policies, giving our clients the information they need to decide whether to support proposed changes or work with us to develop and advocate alternatives.

DeBrunner & Associates provides similar Medicaid consulting services at the federal level, helping our Pennsylvania clients address issues with Congress, the Centers for Medicare and Medicaid Services (CMS), and other federal agencies.