BC Advantage - 2016 Issue 8

When the Government Tries to Change the Rules

We all know that the government doesn't fight fair. This is why it is so critical for healthcare professionals to understand their recourse when the government does not follow their own guidelines. Providing audit appeal defense services to clients all over the country, we are seeing MACs and ZPICs making determinations that lead to significant error rates that turn into demands for refund requests that are significant.The biggest issue we are finding with a lot of these audit performed retroactively is that they are applying guidelines that were not in affect at the time the services were rendered...

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