Audits & Investigations

The attorneys at Weiss Zarett Brofman Sonnenklar & Levy, P.C. routinely represent health care providers in preparing for and responding to audits and site visits for an array of state and federal government agencies, including Medicare and Medicaid, and private carriers. Our attorneys assist clients with responding to subpoenas and requests for information, responding to and appealing audit reports and overpayment demands, helping clients be removed from pre-payment audit review, negotiating settlements and corporate integrity agreements, developing corrective action plans, attending administrative hearings at both the state and federal level, as well representing health providers in civil court litigation on such matters. We routinely work with billing and coding experts, as well as statistics experts in order to help achieve the best possible results.

The attorneys at Weiss Zarett Brofman Sonnenklar & Levy, P.C. are experienced with assisting healthcare providers and facilities with respect to audits and investigations, including but not limited to those involving:

  • CMS – Centers for Medicare & Medicaid Services
    • RAC – Recovery Audit Contractor Audits
    • ZPIC – Zone Program Integrity Contractor Audits
    • MAC – Medicare Administrative Contractors Audits
  • Medicaid (New York)
    • OMIC – Office of Medicaid Inspector General
    • MFCU – Medicaid Fraud Control Unit
  • DOH – New York State Department of Health (DOH)
  • NY AG – New York State Attorney General 
  • OIG – United States Department of Health and Human Services, Office of Inspector General 
  • IRS – Internal Revenue Service
  • DOJ – United States Department of Justice 
  • Commercial (Managed Care) Payor Audits and Investigations

Related Audits & Investigations Publications