Arent Fox’s Health Care attorneys regularly guide clients through issues related to overpayments by Medicare, Medicaid and other government payers. These issues can take many forms, including responding to audits and inquiries by the Office of Inspector General (OIG) or any of a number of government contractors tasked with identifying and recovering funds paid to providers. For providers and suppliers, the acronyms can be disorienting: Recovery Audit Contractors (RACs), Zone Program Integrity Contractors (ZPICs), Medicare Administrative Contracts (MACs), Medicaid Integrity Contractors (MICs), Medicaid Fraud Control Units (MFCU). Arent Fox attorneys can bring some clarity to the regulatory alphabet soup, assisting clients with responding to audit requests and inquiries and, where appropriate, challenging overpayment determinations through administrative appeals.

Following enactment of the Patient Protection and Affordable Care Act (PPACA), providers now have an affirmative obligation to self-report and repay Medicare and Medicaid overpayments within 60 days of  identifying an overpayment. Arent Fox attorneys frequently assist clients in determining when a compliance failure creates overpayment liability, assessing the scope of potential overpayment liability and making disclosures to the appropriate government entity.