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Medicare audits can lead to severe financial penalties and compliance risks for healthcare providers. Without expert legal representation, your practice may face unwarranted sanctions or worse. At Health Law Alliance, we specialize in defending healthcare providers during Medicare audits. Our experienced team helps you navigate the audit process, mitigate risks, and defend your reputation.
Comprehensive Audit Defense: Full representation throughout the audit, from document submission to appeals. As former regulators for the federal government, we use our knowledge of the government's playbook to protect your interests.
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Former Government Regulators on Your Side – Our team of healthcare defense specialists is spearheaded by former federal and state prosecutors who understand how the government and its contractors use data mining and proprietary algorithms to identify potential Fraud, Waste & Abuse (FWA) for audits and investigation. Because we understand how the government builds cases, we use their playbook to beat them.
Healthcare Specialty Attorneys and Consultants – Health Law Alliance specializes in healthcare law and is dedicated to defending providers and their licenses from overreach. Our founding partner previously served as a top executive for the biggest companies in healthcare, including McKesson, Relay Health, CoverMyMeds, United Health Group, Optum, and United Healthcare. We know the tricks insurance companies use to deny claims, and use that inside information against them.
Proven Track Record – Some clients turn to us when stakes are the highest, when their businesses are threatened, when their license is challenged, and when their options are limited. Our wins against the government and insurance companies can be reviewed HERE. Many more clients, however, turn to us at the first sign of potential trouble, when we can neutralize the problem before it grows. Either way, we have your back from beginning to end.
Frequently Asked Questions About Medicare Audits
Do Medicare audits target specific business types?
Medicare auditors often unfairly focus on independent providers versus larger health systems. But all provider types must contend with aggressive Medicare audits. Having experienced legal advocates levels the playing field.
Can your guidance help prevent future unfair targeting by Medicare audits?
Absolutely. We provide tailored Medicare audit compliance recommendations so providers can reinforce areas prone to Medicare audit scrutiny. Proper documentation is critical to rebutting Medicare audit allegations.
Will filing Medicare appeals or settlements impact my network contracts?
Retaliation for exercising Medicare audit appeal rights is prohibited. We incorporate proper legal protections into Medicare audit responses and settlements. Maintaining existing contracts is always a priority.
What recourse exists if advance Medicare audit notice isn't provided?
Lack of 30-day written Medicare audit notice violates statute in many states. We leverage penalties around insufficient Medicare audit notice periods into negotiation leverage.
Can you help if my license or network participation is jeopardized by a Medicare audit?
Yes. We ensure that Medicare audit sanctions comply with applicable federal and state laws. Medicare auditors are prohibited from acting in bad faith or arbitrarily under applicable law and Medicare audit manuals.
What are the costs of legal representation for Medicare audits?
We offer flexible fee arrangements based on the scope of Medicare audit representation required and Medicare audit stage. The earlier we are involved the better, as we can shape and limit Medicare audit scope, making legal representation more effective and less costly.
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