Joanne B. Erde's principal area of practice is in the healthcare industry. She concentrates on representing hospitals and other health care providers on Medicare and Medicaid payment, coverage and compliance issues.
In recent years she has represented healthcare providers across the country in cases before the Provider Reimbursement Review Board, state administrative agencies and the federal courts. She also advises clients in disputes with the Centers for Medicare & Medicaid Service, Medicare fiscal intermediaries and state Medicaid programs regarding regulatory, compliance and false claim issues.
Admitted to practice in both Florida and New York, she is a member of the American Health Lawyers Association and the Health Law Sections of both the Florida Bar and the New York State Bar Association. She is a board certified healthcare lawyer.
Ms. Erde is a 1977 graduate of Hofstra University School of Law and earned a Master of Public Health degree from the University of California at Los Angeles in 1974. She is a magna cum laude graduate of the State University of New York at Buffalo and is a member of Phi Beta Kappa.
- Negotiated the successful termination of an OIG investigation of a nonprofit hospital system regarding allegations of cost report irregularities.
- Advised a large nonprofit hospital system regarding the validity of affiliation agreements for purpose of receiving Medicare reimbursement for IME/GME.
- Advised a group of hospitals regarding the structure to avoid violating the "all or substantially all" criteria of forming practice residency programs in a non-provider setting.
- Successfully litigated numerous challenges to Florida Medicaid rate setting for inpatient and outpatient hospitals service.
- Obtained favorable resolution of application of Bad Debt Moratorium causing hospital to retain $6 million of bad debt reimbursement.
- Negotiated successful settlement of Medicaid false claim investigation regarding psychiatric services, which was resolved by repaying less than 10% of amount originally demanded.
- Advised numerous hospitals regarding the Recovery Audit Contractors.
- Advised numerous hospitals regarding a variety of Medicare bad debt issues; litigated these issues as well.
- Successfully litigated various jurisdictional challenges regarding eligible Medicaid days for purpose of DSH.
- Representing numerous CMHCs in challenge to "Must Bill" rule applied to dual eligible patient bad debts.
- Represented clinics in state challenges to Medicaid participant resulting in a TRO against the state for excluding provider.
- Pursued numerous group appeals challenging exclusion of dual eligible, labor and delivery and general assistance and charity care days from the DSH calculation.
- Obtained favorable resolution of hospitals failure to comply with distinct part unit rules.
- Advised numerous clients regarding obtaining and retaining provider based status.
- Litigated numerous issues regarding IME/GME Medicare reimbursement.
- Successfully negotiated OIG investigation of lab swapping investigation.
Areas of Practice
- Third Party Reimbursement
- Compliance/Fraud and Abuse
- Medicare & Medicaid
- Licensure & Certification
- New York
- Hofstra University School of Law, J.D.
- University of California, Los Angeles, M.P.H.
- State University of New York at Buffalo, B.A.
- Duane Morris LLP
- Partner, 2004-present
- Broad and Cassel
- Partner, 1999-2004
- Steel Hector and Davis
- Partner, 1992-1999
- Mershon Sawyer Johnston Dunwoody & Cole
- Of Counsel, 1986-1992
- Wood Lucksinger & Epstein
- Associate, 1982-1986
- United Mine Workers Health & Retirement Fund
- Assistant General Counsel, 1977-1982
- The Florida Bar - Health Law Section
- American Health Lawyers Association
- New York State Bar Association - Health Law Section
- Healthcare Financial Management Association
- Member, Program Committee, of the AHLA Medicare and Medicaid Institute, 2008 and 2009
Honors and Awards
- Named in The National Law Journal’s list of Health Care/Life Science Trailblazers, 2020
Listed in The Best Lawyers in America, 1995-2020
- Named a Litigation Star by Benchmark Litigation, 2018 and 2019
- Named a "Lawyer of the Year" by Best Lawyers in America in the area of Health Care Law, 2017
- Listed as a Top Rated Lawyer in Healthcare by American Lawyer Media and Martindale-Hubbell™, 2013
- Listed in Legal Media Group/Institutional Investor Magazine's Top 250 Women in Litigation, 2012
- Listed in South Florida's Top Lawyers in the South Florida Legal Guide, 2010, 2012, 2013
- Listed in South Florida's Best Lawyers, 2010 Edition
- Listed in Chambers USA: America's Leading Lawyers for Business, 2006-present
Listed in Florida Super Lawyers, 2006-2015, 2017-2018
- Listed in Florida Trend Legal Elite, 2006-present
- Recognized by Florida Monthly "Best Lawyers", 2004, 2006
- Who's Who in American Law
- HFMA Follmer Bronze Merit, 1999
- AV Preeminent® Peer Review Rated by Martindale-Hubbell®
- "Medicaid Limits for Some Challenged," Daily Business Review, October 11, 2012
- "Hospitals Battle Medicaid Rule Changes Over Undocumented Immigrants," Miami Herald, August 17, 2012
- Co-author, "New Weapons against Fraud and Abuse Under The Affordable Care Act," South Florida Legal Guide, Midyear 2012
- "Another Piece of the Puzzle – The OIG Initiates a New Hospital Audit Program to Focus on Hospital 'Risk Areas'," CCH Health Care Compliance Letter, February 21, 2012
- "PRRB to Review Florida PIP Providers’ Appeal," Dennis Barry's Reimbursement Advisor, September 2010
- "Medicaid Integrity Program — What You Need to Know," CCH Health Care Compliance Newsletter, July 27, 2010
- "Wonder of Wonders, Miracle of Miracles...Favorable DAB Decision on Effective Date of Provider Certification," Reimbursement Advisor, December 2009
- "Medicaid Integrity Program: Piled Higher and Deeper," Modern Healthcare, June 2009
- "CMS Invents Yet Another Way to Delay the Effective Date for Newly Certified Providers," Reimbursement Advisor, April 2009
- "D.C. District Court Decision Gives New Life to Medicare Bad Debt Moratorium," Reimbursement Advisor, August 2008
- "New Medicare Bad Debt Joint Signature Memorandum - History Rewritten," Reimbursement Advisor, July 2008
- "Appealing Your RAC Determination," Sunspots, June 2008
- "Medicare Bad Debts: Are You Losing Money?" HFM Magazine, June 2008
- "Bad Debts: is the Glass Half Empty or Half Full?" Reimbursement Advisor, November 2007
- "Medicare Bad Debts," Modern Healthcare, March 2007
- "Medicaid Integrity Program," Compliance Today, October 2006
- "Bad Debts in the Limelight Again," Reimbursement Advisor, August 2006
- "Recovery Audit Contractors: Is the Honeymoon Over?" Compliance Today, February 2006
- "CMS Reverses Favorable DSH Decisions," Reimbursement Advisor, November 2005
- "Coffee Break is Over: CMS Ends Temporary Hold on Application of Inpatient Rehabilitation PPS Regulations," Compliance Today, November 2005
Selected Speaking Engagements
- "Federal Contractors: RACs, MICs, ZPIC," American Health Lawyers Association Annual Meeting and In-House Counsel Program, Seattle, June 29-30, 2010
- "Update on the Federal Medicaid Integrity Program and other Enforcement Activities," HFMA Florida Chapter 2010 Spring Conference and Annual Meeting, Tampa, May 26, 2010
- "Community Mental Health Centers: Best Practices for Medicare Bad-Debt Reimbursement," Duane Morris LLP Miami office, May 12, 2010
- Speaker and Program Planning Committee, "Federal Medicaid Integrity Program," Institute on Medicare and Medicaid Payment Issues, March 24-26, 2010
- Speaker, HCCA South Atlantic Regional Annual Conference, Orlando, January 29, 2010
- "Ready for the Medicaid Integrity Program?" Healthcare Financial Management Association's Virtual Healthcare Finance Conference and Career Fair, January 12, 2010
- "Ready for the Medicaid Integrity Program? You think RACs are a nightmare? Well, get ready for the MIP!" Healthcare Financial Management Association webcast, November 12, 2009
- "Statewide Medicaid False Claims Act Investigation: Coding of Emergency Room Visits," FHA Corporate Compliance Association Annual Meeting, June 4, 2009
- "Current Issues in Medicare Bad Debts," AHLA Medicare & Medicaid Institute, March 25, 2009
- "Special Issues in New PRRB Rules," AHLA Teleconference, September 9, 2008
- "Collection Agency Bad Debt Issues," ACA Annual Meeting, July 25, 2008
- "Appealing Your RAC Determinations," South Florida Hospital Association, May 9, 2008
- "Medicaid Integrity Program," HCCA Annual Meeting, April 28, 2008
- "Medicaid Integrity Program," HCCA Annual Meeting, April 13, 2008
- "Current issues in Medicare Bad Debts," AHLA Medicare and Medicaid Institute, April 9-11, 2008
- "Medicare Bad Debts," Dixie Institute, February 20, 2008
- "Medicare Bad Debts," Philadelphia HFMA, September 2007
- "Medicare Bad Debts," AHLA Medicare and Medicaid Institute, March 2007
- "Medicare Payment and Cost Report Issues From a Compliance Prospective, "HCCA Southern Region, February 2007
- "Legal Issues Pertaining to the Uninsured," HCCA Southern Region, January 2005
- "Legal and Legislative issues Pertaining to the Uninsured," HFMA Fall 2004 Educational Programs, November 8, 2004
- "Florida Legislative Update," Florida Institute of Certified Public Accountants, April 29, 2004
- "Health Care After Enron," Florida Hospital Association, November 2002
- "Compliance Matters," Florida HFMA, May 2001
- "Things to Look for in Monitoring Cost Reports for Compliance," HCCA's Annual Compliance Institute, September 25, 2000
- "Compliance: Training, Reporting, Disclosing, Investigation," Florida HFMA Annual Meeting, April 29, 1998
- "Help! The FBI is at the Door," Corporate Compliance Forum, October 9-10, 1997
- "Reimbursement Update," American Health Lawyers Association Annual Update, June, Mid 1990s
- "Current Reimbursement Issues," Dixie Institute, March 9, 1994
- "Current Compliance and Reimbursement Issues," A2 Meeting (Association of State Hospital Associations), March 26, 1994
- "Current Medicare Reimbursement Issues," Florida HFMA, May 11, 1994