Medicare and Medicaid Audit Sampling Strategies

Presenting a live 90-minute webinar with interactive Q&A

Medicare and Medicaid Audit Sampling Strategies

Developing Sampling Plans and Challenging Flawed CMS Audit Samples

TUESDAY, AUGUST 14, 2012 1pm Eastern | 12pm Central | 11am Mountain | 10am Pacific

Today's faculty features: Anna M. Grizzle, Member, Bass Berry & Sims, Nashville, Tenn. Patricia L. Maykuth, Ph.D, President, Research Design Associates, Decatur, Ga.

The audio portion of the conference may be accessed via the telephone or by using your computer's speakers. Please refer to the instructions emailed to registrants for additional information. If you have any questions, please contact Customer Service at 1-800-926-7926 ext. 10.

Sound Quality If you are listening via your computer speakers, please note that the quality of your sound will vary depending on the speed and quality of your internet connection.

If the sound quality is not satisfactory and you are listening via your computer speakers, you may listen via the phone: dial 1-866-370-2805 and enter your PIN -when prompted. Otherwise, please send us a chat or e-mail sound@ immediately so we can address the problem.

If you dialed in and have any difficulties during the call, press *0 for assistance.

Viewing Quality To maximize your screen, press the F11 key on your keyboard. To exit full screen, press the F11 key again.

FOR LIVE EVENT ONLY

For CLE purposes, please let us know how many people are listening at your location by completing each of the following steps: ? In the chat box, type (1) your company name and (2) the number of

attendees at your location ? Click the word balloon button to send

Medicare and Medicaid Audit Sampling Strategies

Anna M. Grizzle Partner Bass, Berry & Sims PLC

Patricia Maykuth, Ph.D. President Research Design Associates, Inc.

August 14, 2012

Agenda

? When is statistical sampling and extrapolation used?

? What is the legal basis for statistical sampling and extrapolation?

? How is statistical sampling and extrapolation performed?

? How can I defend against extrapolated overpayment results?

5

Use of Statistical Sampling for Overpayment Estimation

? Acceptable tool in different audits: Medicare, Medicaid, tax, financial statements, etc.

? Appropriate when records are too voluminous for individual review

? Used in Medicare overpayment reviews since the 1970's

6

Use of Statistical Sampling for Overpayment Estimation

? CMS overpayment audit ? OIG self-disclosure protocol ? Internal compliance audit

7

Legal Basis for Statistical Sampling for Overpayment Estimation

"The use of statistical sampling to project an overpayment. . . does not deny a provider or supplier due process. Neither the statute nor regulations require that a case-by-case review be conducted in order to determine that a provider or supplier has been overpaid and to determine the amount of overpayment." HCFA Ruling 86-1

8

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download