Robert Mazer is a shareholder in Baker Donelson’s Baltimore office. Robert Mazer represents clinical laboratories, acute care and critical access hospitals, diagnostic services providers and physicians.
Mr. Mazer advises health care providers on a broad range of payment and compliance issues, including Medicare, Medicaid and other third-party payment rules, the Federal Anti-kickback Statute and the Stark Law. He also represents clients with related disputes with government agencies, CMS contractors and private insurers.
Mr. Mazer has extensive experience with legal, regulatory and business issues related to clinical laboratory and anatomic pathology services. He assists clients with billing, discount and pricing issues, medical necessity criteria and related documentation requirements, lab-to-lab referrals and reference lab agreements, the 70/30 or shell lab rule, issues raised by out-of-network status, including waiver of coinsurance or copayments and deductibles, TC/PC billing, and management contracts, leases and other financial arrangements with physicians, hospitals and other referral sources.
He also defends companies facing government investigations and those who are parties to regulatory or payment disputes, including recoupment actions based on medical necessity determinations or other payment requirements and sanctions under the Clinical Laboratory Improvement Amendments of 1988 (CLIA). Mr. Mazer has successfully defended CLIA revocation actions based on allegations of improper referral of proficiency testing (PT) samples.
Mr. Mazer has significant experience before the Provider Reimbursement Review Board (PRRB), most recently in connection with claims by critical access hospitals (CAHs) for home office or related party costs, and related federal court actions. He is also experienced with application of Medicare reimbursement principles involving depreciation, interest and pension costs.
His financial background, including prior service on the AICPA committee that develops the Audit and Accounting Guide for Health Care Organizations, provides Mr. Mazer with a substantial knowledge base regarding accounting principles, cost computations and fair market value determinations.
Mr. Mazer has co-authored compliance manuals related to Medicare fraud and abuse prohibitions, generally, and the Stark Law, specifically, which were published by Washington G-2 Reports. He has also contributed chapters on legal issues related to clinical laboratory testing and on CLIA, and coding and payment principles applicable to laboratory and pathology services.
Mr. Mazer served as co-chair and program coordinator of a conference addressing financial representation of physicians sponsored by the National Health Lawyers Association and the Maryland Association of CPAs.
- University of Maryland School of Law, J.D., 1979
- University of Maryland, B.S., 1975
- U.S. Court of Appeals for the District of Columbia Circuit
- U.S. Court of Appeals for the Federal Circuit
- U.S. Court of Federal Claims
- U.S. Court of Appeals for the Third Circuit
- Member – American Bar Association
- Member – American Health Lawyers Association
- Member – American Institute of Certified Public Accountants
- Member – Clinical Laboratory Management Association
Rate : $$$$