September 2013

September 26, 2013 Panel Presentation Recap & Video

September 26 2013 Video PresentationMedicare and Medicaid Audits:
Ready or Not, Here They Come

for the video
for the ongoing discussion.

Click "Show more" below the video on YouTube for an interactive video directory. - This presentation by attorneys Christopher E. Brown and Lance O. Leider of The Health Law Firm discusses Medicare and Medicaid audits and fraud. Find out the best practices for protecting yourself and your practice from allegations of fraudulent activity.

00:01 Introduction (Hank Lander)
00:28 Christopher E. Brown Bio (Hank Lander)
01:17 Lance O. Leider Bio (Hank Lander)
02:24 Presentation summary and objectives
03:40 MAC Audits = Medicare Administrative Contractor Audits (Brown)
08:17 RAC Audits = Recovery Audit Contractor Audits (Lieder)
17:09 Prepayment Review (Brown)
17:55 ZPIC Audits = Zone Program Integrity Contractor (Brown & Lieder)
22:50 Responses to all audits and appeals
26:43 Prepare for an audit before it happens
31:04 Checklist for responding to an audit
37:58 Providing records in response to an audit
39:48 Medicaid Audit
44:30 -------------------Questions------------­----------
45:21 What kind of drugs must be included in an audit checklist?
46:29 What happens when 3rd party vendors get audited and need your information?
47:23 How prolific is auditor malfeasance? (Mitchell Gordon)
49:45 What are the biggest trigger events that cause audits?
51:55 What types of providers are audited most?
52:40 Are ACO's under more scrutiny for audits?
53:47 What are the rights for providers to get paid on past due claims? (Loiue Hilal)
55:24 Would you recommend setting up third party billing review?
57:52 What is the time frame for auditors to reply once an audit starts? (R Douglas)
59:38 Is there anyway to recoup costs if your audit comes back clear? (R Douglas)
1:00:59 We are getting requests from 3rd party companies for old should we handle this?

1:02:50 Conclusion & Contact info (Hank Lander)

Medicare Fraud
The federal government relies on physicians to submit accurate and truthful claims. However, dishonest health providers exploiting the system for illegal personal gain have created the need for fraud and abuse laws. Health care providers and professionals servicing Medicare and Medicaid beneficiaries are at risk for increased scrutiny, auditing activity, and overpayment demands from the government. As a medical provider in a state that has become infamous for allegations of health care fraud, Florida health care professionals and providers are particularly at risk.

Mr. Brown and Mr. Leider have extensive experience representing health care professionals and providers in preparing, responding and challenging Medicare and Medicaid audits. Last year Mr. Leider, in part, assisted a North Carolina Medicaid provider in reducing a $1.4 million overpayment demand made by the North Carolina Medicaid Program by more than 98%. Mr. Brown, has represented numerous Medicare providers in ZPIC and RAC audits, as well as Medicaid providers in matter involving the Florida Medicaid Fraud Control Unit. During this presentation they will share trends and patterns in the industry, risk areas and what it means to be excluded from health care programs so you can protect your ability to practice.

Watch Our Panel of Experts as They Discuss This Complex Issue…

Christopher E. Brown Lance O. Leider    
Christopher E. Brown
Lance O. Leider

CHRISTOPHER E. BROWN, J.D. has practiced health care law on an exclusive basis since graduating from Barry University School of Law in May 2009. He represents physicians, dentists, nurses, pharmacists, massage therapists and other health care providers on a wide range of professional issues. His practice encompasses both health law and administrative law. Mr. Brown is involved in the representation of health care providers in licensing matters, the defense of health professionals in Medicaid audit cases, prepares appeals of administrative law cases, commercial litigation in state courts, preparation and negotiation of contracts, and has experience negotiating with the Professionals Resource Network (PRN).

Mr. Brown is admitted to practice law in all Florida state courts. He is also admitted to the U.S. Court of Appeals for Veterans Claims. He received his Bachelor of Arts from Coastal Carolina University, Conway, South Carolina, in 2005.

One of Mr. Brown’s strengths is physician contracting. Because of his experience, he was featured in an American Medical News article, called “Physician Employment: Build a Contract That Suits You.” Mr. Brown regularly presents seminars to Orlando medical residents on the topic of contract negotiations and employee contract reviews. He also writes a blog series for The Health Law Firm website called, “Contracting 101: Tips for Physicians and Health Professionals.”

Mr. Brown is a member of the Seminole County Bar Association, Orange County Bar Association, American Health Lawyers Association (AHLA), The American Association of Nurse Attorneys (TAANA) and Health Law Section of The Florida Bar.

LANCE O. LEIDER, J.D. is an attorney representing health care providers on a wide range of professional issues. His practice focuses on the representation of health providers in litigation, licensing and disciplinary issues, contracts, appeals, administrative hearings, regulatory matters, and Medicare and Medicaid defense. 

Mr. Leider is licensed to practice in the state of Florida and is a member of The Florida Bar Health and Administrative Law sections. Mr. Leider is also admitted to the U.S. Court of Appeals for Veterans Claims.

Mr. Leider obtained his Bachelors of Arts Degrees in Philosophy and Political Science from the University of Florida, Gainesville.

Mr. Leider earned his J.D. degree summa cum laude from the Barry University, Dwayne O. Andreas School of Law in December 2011. He was the valedictorian of his class and served on the Editorial Board of the Barry Law Review as Lead Articles Editor. During law school Mr. Leider also served as a judicial intern to Judge Belvin Perry during the Casey Anthony trial.

As a result of his exceptional performance on the Florida Bar Exam, Mr. Leider was invited by the Fifth District Court of Appeal to address the new inductees being sworn in on May 8, 2012 in Daytona Beach. Click here to view a letter congratulating Mr. Leider on being selected to speak on behalf of the Florida Bar admittees.