Pediatricians Who Are Targets of Medicaid Audits Should Request Hearings on the Final Audit Report Results
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
We have recently been contacted by several pediatric practices that were subject to Medicaid audits. In several cases, the pediatricians received the final audit reports (FARs) stating that they owed Medicaid refunds, because of overbillings, in the tens of thousands of dollars.
With such demands for repayment of the alleged overpayments also come:
1. Fines;
2. Penalties;
3. Requirements to sign agreements to refrain from such practices in the future;
4. Requirements to have personnel retrained; and
5. The specter of future audits.
In many cases, Medicare and Medicaid auditors may swiftly review supporting medical records and overlook key components that support the level […]