HCPro Boot Camp Instructor

Alicia Kutzer

Alicia Kutzer, Esq., LL.M., M.H.A., serves currently as an adjunct instructor for HCPro’s Medicare Boot Camp® – Hospital Version. In addition, she is a licensed attorney in the State of Pennsylvania and is a managing partner of Kutzer Law Firm, LLC, located in the Wilkes-Barre/Scranton area, founded in 2011.

Ms. Kutzer served as an Administrative Law Judge in over 1000 Administrative Fair Hearings for Federal Hearings and Appeals Services, Inc., from August 2016 through February 2017. Prior to that, Ms. Kutzer was a Post-Adjudication Appeals Officer, Appeals Officer, and Subject Matter Expert for MAXIMUS, Inc., a Medicare Qualified Independent Contractor (QIC), from April 2012 through November 2015.

As an Appeals Officer, she was responsible for evaluating appeals and authoring determinations for all Medicare Part A and Medicare Part B of A cases at the Reconsideration level of appeal (i.e., 2nd level of appeal). She authored an average of nearly 20 appeal decisions daily, based on review of case files, including documentation submitted by appellants, documentation submitted by lower-level contractors and relevant regulations.  As a Post-Adjudication Appeals Officer, she reviewed Reconsideration decisions to defend those decisions in Administrative Law Judge hearings (i.e., 3rd level of appeal). She acted as lead attorney for MAXIMUS in Administrative Fair Hearings pertaining to RAC audits, ZPIC audits for inpatient and outpatient care, home health, hospice, skilled nursing facilities, inpatient rehabilitation facilities and partial hospitalization programs. She participated in over 1000 ALJ hearings as an attorney for MAXIMUS and was routinely in communication with appellants, including healthcare systems, healthcare agencies, attorneys, and business associates of appellants. Ms. Kutzer authored position papers and training modules and other learning materials for MAXIMUS to ensure accurate and legally sound determinations. She presented training seminars to other MAXIMUS attorneys and employees regarding RAC and ZPIC overpayment regulations and appeals.

Ms. Kutzer has been a licensed attorney in Pennsylvania since 2010 and has an LL.M. in Corporate Law and Finance and a Master’s Degree in Healthcare Administration from Pennsylvania State University.