So you can have providers facing multi-million dollar overpayment demands. They do these audits and then come up with an error rate and extrapolate. They are instigated by suspicion of fraud that is the result of data mining, primarily. They go out and do these audits, and a lot of times providers believe these are routine audits like the RAC audits or just regular commercial payer audits that you deal with in the ordinary course of business, and UPICs are not that. So, they're private companies under contract. They contract with CMS stands for a Unified Program Integrity Contrator. Those seemed bad enough and hard enough for healthcare providers to navigate and then, about 10 years ago, I was retained by a client that was facing a UPIC audit.
I've been representing healthcare providers for over 20 years now and mostly focused on their dealings with the Department of Justice and False Claims Act investigations. You both have extensive experience working with healthcare providers, facing government audits and investigations across the country.īefore we get into the specifics of our conversation today, I would love to hear from both of you and to share with our listeners a little background about yourself and how you all came to work together. Jennifer: Thanks very much for having us, Morgan. Jon and Jennifer, thank you for joining us today. Today, we're going to discuss the government audit landscape for healthcare providers and what they can do to safeguard their organizations, and if audited, how they can respond. On today's episode, we are joined by Jon Rawlson, founder and president of Armory Hill Advocates, a government affairs firm that represents healthcare clients in the nation’s Capital and in several state legislatures and Jennifer Weaver, co-chair of Waller's healthcare industry team and partner in the firm's government investigations and litigation group. This is Morgan Ribeiro, the firm's Chief Business Development Officer and the host of the podcast. Pre-Record: Welcome to PointByPoint conversations, interviews, and legal commentary for today's business professionals brought to you by Waller.
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