Medicare and Medicaid Audits
Health
care fraud is a persistent and costly problem both for commercial and
government payors. The Centers for Medicare & Medicaid Services (CMS)
estimates that a significant amount of fee-for-service payments are misspent on
improper payments every year. To address health care fraud, Congress and CMS
have developed a variety of approaches over the past several years to audit
Medicare and Medicaid claims. The tables in this article summarize the major
types of Medicare and Medicaid audits that could affect physicians. Entities
responsible for these audits include:
Ø Medicare Recovery Audit Contractors (RACs)
Ø Medicaid RACs
Ø Medicaid Integrity Contractors (MICs)
Ø Zone Program Integrity Contractors (ZPICs)
Ø State Medicaid Fraud Control Units (MFCUs)
Ø Comprehensive Error Rate Testing (CERT)
Ø Payment Error Rate Measurement (PERM)
Have you been
contacted regarding a potential audit?
Do you have
concerns of an Audit ?
Join AccuChecker at YahooGroups for OnLine chat or one of
our many Webinar…
HPP Management Group
5201 Blue Lagoon Drive
Suite 800
Miami, Florida 33126
Phones: 305-227-2383 or 1-877-938-9311
support@accuchecker.com
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