Almost every company that works with Medicare and Medicaid will at some point face a ZPIC or Express Script audit—that are investigations onto fraud waste and abuse. When a business receives notification of an audit it is imperative that they immediately engage experienced counsel to help them through the process. Our attorneys have handled ZPIC and Express Script audits for home healthcare companies, durable medical equipment companies, laboratories, pharmacies, hospices and medical practices.
We have extensive experience in data mining and analysis which is invaluable in assisting a providers’ response to pre-payment and post-payment audits. An adverse result to an audit can result in large repayments to the government, program suspension and in some cases referral to HHS OIG for further investigation.