Medicare 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. 

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

Our Medicare Audits & Investigation Services

Our attorneys assist clients in myriad ways, including:

  • Responding to subpoenas and requests for information
  • Responding to and appealing audit reports and overpayment demands
  • Helping to remove clients from pre-payment audit reviews
  • Negotiating settlements and corporate integrity agreements
  • Developing corrective action plans
  • Attending administrative hearings at both the state and federal level
  • 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.

Audits and Investigations FAQs

How can one of these audits negatively affect me? Most audits do not result in any sort of disciplinary action, but there is always the possibility of having to pay a fine, adjust the structure of your practice, or even having your practice shut down entirely as a worst-case scenario.

How do I avoid audits and investigations? The simplest way to avoid audits and investigations is to abide by all local, state, and federal laws and regulations regarding your practice. 

What should I do now that an audit has been called? If you have received information that you are going to be audited, one of the first steps to take is to contact competent legal assistance. You may also want to start compiling the relevant documents and testimonies for your own reference and to help your legal team. 

Defend Your Practice With Weiss Zarett Brofman Sonnenklar & Levy, P.C. 

Audits and investigations are almost always an annoyance or hindrance for any medical practice, but Weiss Zarett Brofman Sonnenklar & Levy, P.C., is prepared to walk with you through every step of the process. We take on the legal hurdles for you so you can practice improving the health and life outcomes of your patients. Contact us today via phone, email, or our contact form below to begin working with us!