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Audits Medicare Contractors

Faegre Drinker Biddle & Reath LLP

Brace Yourself: The RACs Are Back

Under the controversial program private contractors audit hospitals and other Medicare providers for fraudulent and erroneous Medicare billing. Why is it controversial? Because the auditors are paid a percentage of...more

King & Spalding

Third Circuit Holds Judicial Review of Extrapolated Overpayment Determinations is Precluded

King & Spalding on

On February 12, 2014, the U.S. Court of Appeals for the Third Circuit held that Federal courts do not have jurisdiction to review HHS’s determination of a “sustained or high level of payment error,” one of two possible...more

King & Spalding

GAO Calls For Consistency Among Medicare Contractors Postpayment Claims Review

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The U.S. Government Accountability Office (GAO) recently published the results of a study examining the effectiveness of CMS’s contractors that conduct postpayment claims reviews to identify improper payments (i.e., Medicare...more

King & Spalding

CMS Announces New Unified Program Integrity Contractors

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CMS recently announced plans to implement a new Medicare and Medicaid program integrity contractor, Unified Program Integrity Contractors (UPICs). ...more

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