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Arnall Golden Gregory LLP

OIG Weighs-In on the Review of Extrapolated Overpayments in the Medicare Appeals Process

Arnall Golden Gregory LLP on

The financial stakes are often very high for providers when statistical sampling and extrapolation is used to calculate an alleged Medicare overpayment. In post-payment audits involving extrapolation, an actual claims denial...more

Hogan Lovells

False Claims Act Alert: Fourth Circuit Punts on Sampling and Extrapolation

Hogan Lovells on

Tuesday, the Fourth Circuit Court of Appeals ruled in the interlocutory appeal in United States ex rel. Michaels v. Agape Senior Community, Inc.. In an opinion considering two significant questions arising under the qui tam...more

Baker Donelson

No Judicial Review of Contractor’s Finding of a High Payment Error Rate, a Condition for Extrapolation

Baker Donelson on

Before a Medicare contractor can use extrapolation to determine an overpayment amount, the Medicare statute requires that it must make a finding that there is a sustained or high level of payment error or that documented...more

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