Medicaid Integrity Contractor Audits: Know What to Expect and How to Prepare
Product Description:
Audio Conference on CD or Audio On-Demand
Sponsored by Revenue Cycle Institute
A program for revenue cycle, patient financial services, compliance, and auditing professionals
presented on October 15, 2009
Medicaid Integrity Contractors (MIC) have already begun auditing for inaccurate billing of Medicaid services as part of the Medicaid Integrity Program’s efforts to combat waste, fraud, and abuse. And with Medicaid losses running at an 18.5 percent error rate, there are many dollars for MICs to find and take back.
But many providers are unfamiliar with the Medicaid Integrity Program and MIC audits, and have plenty of questions and concerns about what is coming, and how to prepare. This audio conference provides a thorough explanation of the program, including how state and federal efforts will function together during the audit process. Our speakers also discuss your procedural rights, how to challenge and appeal audit findings, as well as explain timelines and other challenges unique to Medicaid Integrity audits.
NOTE: This is an intermediate-level program. Purchasers will want to review material from the CMS Web site on the Medicaid Integrity Work Plan 2009-2013, Medicaid Annual Report FY 2008.
LEARNING OBJECTIVES
At the conclusion of this audio conference, you will be able to:- Describe the current state of the Medicaid Integrity Program
- Outline how state laws interact with federal Medicaid auditing activity
- Explain strategies to prepare for MIC audits
- Explain the challenges and complexities involved in Medicaid auditing
- Describe how and when MIC activity will begin in your area
TAKE A LOOK AT THE AGENDA:
- The Medicaid Integrity Program and Medicaid Integrity Contractor (MIC) audits
- Regulatory basis for the program
- How and when the program is being rolled out across the country
- Three types of MICs (review, audit, educational)
- Current state of the program
- MIC audit process
- How MICs will determine what, and whom to audit
- What to expect during a MIC audit
- How Medicaid state requirements affect the MIC auditing process, including timelines, appeals, recoupments, and medical record requests
- The process in New York and other states
- Discussion of challenges surrounding MIC audits and how to address them
- Data issues
- Recoupments
- Statistical sampling and extrapolation issues
- Federal and state interaction
- Disclosure programs
- Compliance issues raised by MIC audits
- Strategies for MIC audit preparation
- Techniques to help ensure you meet audit deadlines
- Identify and understand the relevant guidelines affecting the MIC process in your state
- Proactive ways to identify and correct errors before MICs do
A question and answer session follows the presentation.
MATERIALS
In addition to the expertise and advice presented during this audio conference, you'll also receive a slide presentation of the program materials and:- Grid illustrating MIC regions and procurement timelines
- Yellow book – auditing standards
These materials are provided with PDF links.
MEET THE SPEAKERS
James G. Sheehan is the New York State Medicaid Inspector General. He is the former Associate U.S. Attorney for Civil Programs in the Eastern District of Pennsylvania. He has focused his career on healthcare fraud since 1987 and personally handled or directly supervised more than 500 healthcare fraud matters.Sara Kay Wheeler practices exclusively in the area of health law. She has extensive experience in the creation and implementation of corporate compliance programs, Medicare and Medicaid regulation, fraud and abuse concerns, internal investigations, voluntary disclosure strategies, and clinical research compliance.
WHO SHOULD LISTEN?
Compliance officers and staff; internal audit staff; revenue cycle, patient financial service, HIM, and coding managers and directors; outside consultants, legal counsel, and CFOs in hospitals, pharmacies, long-term care facilities, and physician offices.AUDIO ON-DEMAND
In addition to the regular purchase options for HCPro audio conferences, we are pleased to offer another option, audio on-demand. Audio on-demand allows you to download the program and play it back at your convenience through your computer or MP3 player. Purchase a CD or audio on-demand of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.Product Types : Departments :
