Monday, September 18, 2017: 10:15 AM-11:45 AM
-
Faculty:
Meg S.L. Pekarske, JD
,Reinhart Boerner Van Deuren S.C., Madison, WI
and
Karla Pinkerton, JD
,Reinhart Boerner Van Deuren S.C., Madison, WI
Working with hospices throughout the country, the presenters have been intimately involved with all types of government audits and have been on the frontline in responding to the latest government contractor trends. In this session, faculty will share their insights regarding what they’re seeing in the realm of Zone Program Integrity Contractors (ZPIC) and Medicaid Integrity Contractors (MIC), in addition to their most recent experience with two of the new Unified Program Integrity Contractors (UPIC). These trends range from serial record requests, patient interviews, and auto-denied claims initiated by ZPICs to an increased focus on state-specific technical requirements (e.g., election, certification, and prior-authorization forms) by MICs. Participants will learn how to recognize these trends in the midst of an audit, along with potential strategies for addressing and responding to some of the contractors’ most egregious new tactics.
Learning Objectives:
1. Discuss recent trends in UPIC, ZPIC and MIC audits, including serial record requests, patient interviews, and auto-denials
2. Identify how to recognize these trends in the midst of an actual audit
3. Describe strategies and resources for addressing and responding to these trends