Medicare Audit Guidance

With ZPICs, PSCs, and RACs Fighting Most, If Not All, Extrapolation Challenges, Experienced Counsel Is Imperative if You Hope to Have the Extrapolation Invalidated

(July 20, 2010): In recent years, we have seen agents for the Centers for Medicare... 

South Texas Medicare Providers. . . Watch Out! ZPICs Are In Town and They Are NOT Happy

(July 16, 2010):  If there were ever any doubts that ZPICs are going to make their... 

“Finders Keepers” May Apply in the Schoolyard But It Doesn’t Apply to Medicare Overpayments

(July 15, 2010):  Since the May 2009 passage of the Fraud Enforcement and Recovery... 

HHS-OIG Issues Its Semi-Annual Report for the First Half of Fiscal Year 2010

(July 11, 2010): As set out in HHS-OIG’s Semi-Annual Report covering the first... 

President Obama Appoints New Head of CMS

(July 9, 2010): On Wednesday, President Obama announced the recess appointment of... 

What is Causing the Spike in Partial Hospitalization Overpayment Actions?

(June 29, 2010): Are Partial Hospitalization Programs (PHPs) and Community Mental... 

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ZPIC / PSC / RAC Audit Issues

As Noted at the Los Angeles DOJ / HHS Health Care Fraud Summit — Data Mining is Being Used by DOJ to Target Health Care Providers

(August 31, 2010):  Introduction: Last week, department heads of the U.S. Department... 

Don’t Take ZPICs’ or RACs’ Extrapolation Calculations at Face Value — Can Their Results Be Readily Reproduced? Don’t Fail to Address These and Other Deficiencies in the Contractor’s Actions

(July 14, 2010): Imagine a ZPIC, PSC, or RAC hands you a claims analysis rife with... 

Are ZPICs Using “Sampling” to Maximize Medicare Overpayment Recoupments? Unfortunately, Yes. . . Here’s How We Fight Back. . .

(July 12, 2010):  A ZPIC’s use of extrapolation can be a surefire way of destroying... 

Look at RACs — Part III: What Should Physicians and other Medicare Providers Know about Appeals and Recoupment?

(July 2, 2010):  CMS’ Recovery Audit Contractor (RAC) program is now permanent... 

A Look at RACs — Part II: How Should Physicians and Other Providers Respond to a RAC Audit?

(June 28, 2010): In Part I of this series, we reacquainted you with the design and... 

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HEAT

Texas Psychiatrist Indicted and Arrested

(July 9, 2010):  On June 14, 2010 the U.S. Attorney’s Office for the Western District of Texas announced that a Federal Grand Jury had returned a 99-count indictment against a pain management physician who operated clinics in San Antonio and El Paso.  The physician was charged with 21 counts of health care fraud, 20 counts of false statements relating... [Read more of this review]

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    The content on this web site is provided as a public service. It is not approved, endorsed or authorized by the Social Security Administration, the Centers for Medicare and Medicaid Services, or the Department of Health and Human Services. The provider of this web site does not have any connection with, or authorization from, the Social Security Administration, the Centers for Medicare and Medicaid Services, or the Department of Health and Human Services. The information on this web site is provided free of charge. It is provided as general information only. It does not constitute legal advice and should not be used as a substitute for seeking legal counsel. Should you need legal advice, you should contact your attorney if you have one. Liles Parker PLLC, Attorneys and Counselors at Law, represents a wide variety of health care providers in alleged overpayment disputes. You may call 1 (800) 475-1906 for a free consultation. 4400 MacArthur Blvd, NW, Suite 203, Washington, DC 20007.