In today’s health care industry, audits of health care providers by the government are increasingly common. Legislation over the past several years has increased the funds available to the federal government for it to investigate and attempt to recoup overpayments made to providers pursuant to its programs (Medicare, Tricare and Medicaid). Medicare RAC (recovery audit contractors) audits are part of the alphabet soup lexicon well known to providers.
These government audits may result in a determination of an overpayment made to the provider, in which case the provider is expected to reimburse this sum. In addition to the costs of going through the audit and the amount of the overpayment assessment itself, providers must pay out considerable expenses if they desire to fight an assessment. These costs may include legal counsel, retention of expert analysts, legal filing costs and others.
