Escalating Medicare and Medicaid Auditing on the Horizon

Feeling overwhelmed? When it comes to MIC audits, you may have an ally. In New York, for example, a topic on the table is minimizing the burden on hospitals and other providers. So Sheehan suggests that if you're overwhelmed and your MIC isn't responsive, it might be wise to go to the program integrity head in your state.

"If you don't get a positive response from your MIC when you say, 'Hey, we've got 20 audits stacked up here. Can you please take your place in the queue?' then go back to the state and tell them you need some relief in the short term."

Editor's note: Wheeler and Sheehan spoke during the October 15 HCPro audio conference, "Medicaid Integrity Contractor Audits: Know What to Expect and How to Prepare." For additional background information, view the April 22, 2009 GAO report "Improper Payments: Progress Made but Challenges Remain in Estimating and Reducing Improper Payments."