Over the last few years, our Firm has seen a significant increase in cases where CMS and its agents (typically Program Safeguard Contractors (PSCs) such as AdvanceMed and TriCenturion) have conducted audits where a "statistically relevant sample" has allegedly been taken in connection with the government's review of Medicare claims.   Disturbingly, in cases we have seen, it is not uncommon for TriCenturion and other PSCs to purportedly find claims errors rate of between 85% and 95%.  Extrapolating these findings to the universe of claims, they have then sought to recover most, if not all of the funds a provider has been paid by Medicare during the 2-4 year period at issue.

Liles Parker, PLLC has represented a wide variety of providers in challenging the validity of these statistical extrapolations.  Our attorneys have extensive experience identifying the many flaws that may have been made by the government's contractors in connection with these statistical extrapolations.  Moreover, we are skilled at appealing claims throughout the appeals process, presenting arguments in support of payment based on the care provided and the medical necessity of the services rendered.

The trust we have developed with our clients is the foundation of our success.  Should you have questions regarding Medicare claims damages extrapolations, please give us a call.