ZPIC Medicare Audits: Lessons Learned From CMS Scrutiny
Navigating the Complex Audit and Appeals Processes
Recording of a 90-minute CLE webinar with Q&A
This CLE course will provide guidance to healthcare counsel on preparing for CMS's Zone Program Integrity Contractor (ZPIC) audits. The panel will examine lessons learned during the first year of ZPIC audits, outline steps to minimize the risk of such audits, and offer strategies for appealing unfavorable audit results.
Outline
- ZPICs audits
- Role of ZPICs
- Contractor authority
- Role of extrapolation
- Fraud and abuse consideration
- Preparing for ZPICs
- Compliance program
- Risk assessments
- Training
- Response to findings and appealing ZPICs
- ZPIC audit process
- Appeal process
- Potential defense issues
Benefits
The panel will review these and other key questions:
- What are the key steps healthcare providers can take to minimize the risk of a ZPIC audit?
- What can healthcare providers do now to prepare for a potential ZPIC audit?
- What are the best practices for healthcare providers to challenge an unfavorable audit outcome?
Following the speaker presentations, you'll have an opportunity to get answers to your specific questions during the interactive Q&A.
Faculty
Sara Kay Wheeler
Partner
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.
CloseSteve Lokensgard
Special Counsel
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