The Research Design Associates Blog

(Medicare audit)

Help for Audited Medicare Providers

CMS contractors audit providers of Medicare services on a contingency-fee basis to find improper overpayments. With intense pressure to investigate fraud, and audit contractors incentivized with contingency fees to find improper overpayments, the audit system itself is ripe for error and abuse. Statistical analysts at Research Design Associates have expertise in challenging the sampling and extrapolation process. Often working with law firms representing providers in Medicare overpayment disputes, we investigate every phase of the process. Errors in sampling design and/or statistical analysis can generate hundreds of thousands of dollars of incorrect extrapolated overpayments. It is worthwhile considering a challenge to audit statistical methodology since a successful challenge could nullify the extrapolation.

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