New ZPIC Medicare Audits: Are You Ready?
Preparing for Heightened CMS Enforcement Against Fraud and Abuse
Recording of a 90-minute CLE webinar with Q&A
This CLE webinar will provide guidance for healthcare counsel to understand and prepare for CMS's new Zone Program Integrity Contractor (ZPIC) audits. The panel will outline proactive steps to minimize the risk of such audits and offer strategies for appealing unfavorable audit results.
- Role of ZPICs
- Identifying vulnerabilities in the Medicare program
- Identifying and investigating potential fraud cases
- Referring cases for prosecution
- Data analysis
- ZPICs audits
- Contractor authority
- Role of extrapolation
- Fraud and abuse consideration
- Preparing for ZPICs
- Compliance program
- Risk assessments
- Strategies for responding to inquiries and appealing ZPICs
The panel will review these and other key questions:
- What can a healthcare provider expect to happen during a ZPIC audit?
- What are the key steps healthcare providers can take to minimize the risk of a ZPIC audit—and prepare for a potential ZPIC audit?
- What are the best practices for healthcare providers to challenge an unfavorable audit outcome?
Sara Kay Wheeler
King & Spalding
She has extensive experience in the creation and implementation of corporate compliance programs and investigations,... | Read More
She has extensive experience in the creation and implementation of corporate compliance programs and investigations, government contractor audits, including ZPICs, Medicare regulation, Medicaid regulation, fraud and abuse concerns, internal investigations, voluntary disclosure strategies, clinical research compliance, privacy matters and managed care arrangements.Close
Faegre & Benson
He has extensive experience with identifying and managing regulatory and financial risk. He assists healthcare clients... | Read More
He has extensive experience with identifying and managing regulatory and financial risk. He assists healthcare clients with a variety of claims appeals and compliance matters, including preparation for and response to Medicare audits. He also provides counsel on issues related to transactions, fraud and abuse enforcement, HIPAA privacy, billing and reimbursement, and general health law.Close