skip to main content
Paul L. Croce
x
x

Paul is a healthcare attorney and litigator with focused expertise in hospital reimbursement and guardianship matters. He represents hospitals and healthcare systems before the Department of Health and the Division of Medical Assistance and Health Services in Medicaid and Medicare appeals, Disproportionate Share Hospital (DSH) subsidy appeals, Graduate Medical Education (GME) subsidy appeals, and other legal challenges.

Paul represents nursing homes, assisted living facilities and other long-term care providers in guardianship applications seeking the appointment of permanent or temporary guardians to make necessary decisions for  residents who lack capacity  and appropriate surrogate decision makers.  

As a healthcare litigator, Paul has experience with Fifth Amendment Takings cases, matters involving nursing home discharges, and the defense of breach of contract and tortious interference claims. His work also includes the defense of attorneys and other licensed professionals against claims of malpractice and ethics grievances. He provides counsel on issues related to contracting, civil litigation and professional licensing matters, representing a variety of healthcare industry clients including physicians, dentists, hospitals and for-profit and nonprofit healthcare systems.

Results may vary depending on your particular facts and legal circumstances.

Bar Admissions

  • New Jersey, 2008
  • New York, 2009
  • U.S. District Court, District of New Jersey, 2008

Education

  • Seton Hall University School of Law, J.D., cum laude, 2008
  • Arizona State University, B.A., 1998

Representative Matters

  • The firm represented a coalition of New Jersey hospitals in a $300 million constitutional challenge to the State of New Jersey’s charity care and Medicaid reimbursement regime, defending the hospitals’ takings claims through summary judgment, Appellate Division review, and New Jersey Supreme Court proceedings, resulting in published decisions affirming dismissal of the claims. The hospitals filed a petition for certiorari with the Supreme Court of the United States, which was denied.
  • Represented a leading senior care provider in dozens of guardianship proceedings for residents lacking family decision-makers, coordinating with the New Jersey Office of the Public Guardian to secure medical authority and Medicaid eligibility.
  • Representing two New Jersey health systems in high-stakes litigation against multiple Medicare Advantage plans seeking recovery of approximately $5 million in underpaid 340B drug reimbursements, following a U.S. Supreme Court decision invalidating the Center for Medicare and Medicaid Services’ reimbursement reductions; matters are proceeding toward mediation and arbitration.

 

Memberships

  • Healthcare Financial Management Association New Jersey Chapter: Regulatory & Reimbursement Committee (Co-Chair 2022 – 2024)

Client Alerts

Published Articles

Of Interest