Medicare and Medicaid audits can be frustrating, intimidating, and overwhelming. If you receive an audit letter from a public healthcare program, you should consult with an attorney about your rights and responsibilities. Failure to comply with an audit can have serious repercussions, including civil money penalties, sanctions, and terminations.
At The Callahan Law Firm, we provide experienced legal counsel for healthcare professionals who have received notification that an audit has been initiated by the Centers for Medicare & Medicaid Services or a request for medical records. Our attorneys will walk you through the process and ensure you are in compliance with the request. If you are facing a Medicare or Medicaid audit, contact our office at (312) 209-9394 to schedule a confidential consultation.
Responding to a Medicare/Medicaid Audit
A proper response to an audit requires you to navigate a complex environment of billing codes, standards of practice, charting, and administrative regulations. Without the help of an attorney, you could face the maximum penalties allowed by the Centers for Medicare & Medicaid Services (CMS).
The CMS may take enforcement actions against healthcare providers who:
- Fail to comply with program or contract requirements;
- Do not carry out the contract in a manner consistent with regulatory requirements; or
- Are unable to substantially meet the conditions of the program.
CMS conducts both field and office audits. Working with an attorney as early in the process as possible can help ensure that you are compliant with the audit requirements and that your matter is resolved as quickly as possible. Our attorneys understand that healthcare audits can have a devastating impact on a medical practice. We have tremendous experience helping clients mount a careful, well-researched, and appropriate response.
What to Do If You Receive an Audit Letter from the CMS
If you receive an audit notification from the Centers for Medicare & Medicaid or another regulatory agency, you need to consult with an attorney. Failing to respond or comply could be detrimental to your medical practice and may result in the termination of your contract. A termination will result in your ineligibility from receiving Medicare or Medicaid reimbursements.
As soon as you receive an audit letter, you should start gathering the appropriate documentation needed for compliance. If medical records are requested, be sure to begin assembling the necessary information as soon as possible. A timely response may prove critical in your case, but it should not be done hastily. It is strongly recommended that an attorney review the information to determine the best course of legal action following the notification of a regulatory audit.
Contact The Callahan Law Firm for More
If you have received a healthcare audit notification from the Centers for Medicare & Medicaid Services or another agency, you need to be prepared. You are required to respond. Failure to respond timely can result in sanctions or even termination.
At The Callahan Law Firm, our legal team can help you prepare a comprehensive response to the audit, ensuring you are in compliance with the request. We will guide you through the process, reducing your exposure and helping to resolve the matter as quickly and efficiently as possible. Contact our office at (312) 209-9394 to schedule a confidential consultation today.
