Focusing on the Other "M" Word - Taking a Closer Look at Preparing for and Rebutting Medicaid Integrity Audits

Thursday, April 21, 2016: 4:00 PM-5:00 PM
National Harbor 10 (Gaylord National Resort and Convention Center) - 3rd Level
Meg Pekarske, JD, Reinhart Boerner Van Deuren S.C., Madison, WI and Bryan Nowicki, JD, Reinhart Boerner Van Deuren S.c., Madison, WI
Over the past year and a half, we have seen an increasing number of hospices across the country facing Medicaid Integrity Contractor ("MIC") audits.  Similar to the feared ZPIC, MIC audits are "integrity" (i.e., fraud) focused and are completed by federal government contractors hired by CMS to review claims paid by state Medicaid agencies. If your hospice becomes the target of a MIC audit, are you prepared? Faculty will share their experience in helping hospices prepare for and survive MIC audits, including those that occur on-site with interviews. In addition, the audience will learn about common denials and strategies for using the rebuttal process to overturn unfavorable results.

Learning Objectives:
1. Identify trends in MIC audits and know who auditors are targeting
2. Describe how to prepare for the audit records production process and for an on-site visit with interviews
3. Discuss strategies for rebutting the draft audit results, if unfavorable

CE/CME: Nurse, Physician and Social Worker