Advantage Legal Seminars :: Medical Records :: Preparing for Medicaid Audits

Preparing for Medicaid Audits

Preparing for Medicaid Audits

The current and future state of Medicaid audits û are you and your clients adequately prepared? The Medicaid program is a stateÆs most significant health care expense and, in many instances, one of its largest budgetary items. It is the health insurer of last resort for children and the economically disadvantaged. The recent economic downturn has caused shortfalls to many statesÆ overall budgets. Those states are now looking toward Medicaid providers to make up the shortfall through the use of post payment audits and overpayment recovery. The use of statistics based upon a small sample of claims but extrapolated over an entire population of claims can lead to multimillion-dollar overpayments. The typical overpayment is no longer solely based on a medical necessity analysis, but instead extends to instances of technical noncompliance of the most insignificant nature. Failure to prepare and to adequately respond even if prepared may subject a provider to the harshest of consequences. This teleconference is critical to any provider enrolled in the Medicaid program who desires to stay in the program.

Faculty: J. Everett Wilson, Akerman Senterfitt

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