Preparing For a Medicaid Audit: How Spodek Law Group and Attorney Todd Spodek Can Assist You

As a healthcare provider in Los Angeles, you know that being reviewed by a Los Angeles Recovery Audit Contractor (RAC) is a possibility. Since the expansion of the healthcare reform legislation, RACs have been given the power to review Medicare parts A, B, C, and D claims, as well as Medicaid. If you’re facing a Medicaid investigation, audit, or litigation process, having qualified Medicaid healthcare audit lawyers like Spodek Law Group and Attorney Todd Spodek in your corner can make all the difference, especially when replying to a Medicaid audit notice.

The primary purpose of Medicaid audits is to address issues raised by government agencies. To do this successfully, you need to provide accurate responses to all the audit questions provided. Incorrect responses can be used against you later, including in a litigation process. Some Medicaid proceedings can lead to criminal prosecutions. For instance, if the Medicaid auditor identifies that treatment to some of your patients was necessary, they can dig deeper. Such a review can cause further inquiries into your practice, lead to reimbursement for all losses incurred, and in some cases, even suspension of your Medicaid number.

What You Should Know About Medicaid Audits

While most healthcare providers focus more on Los Angeles Medicare Recovery Audit Contractors, paying attention to the Medicaid Integrity Program (MIP) is also crucial. The MIP was created to detect and prevent Medicaid fraud, mandated by the 2005 Deficit Reduction Act, and all states were required to hire Medicaid Integrity Contractors (MIC’s) to audit, review, and educate. MIP was also meant to recover Medicaid payments and provide technical support to state Medicaid agencies.

The Auditing Process

Once you are chosen for a Medicaid audit, you will be referred to a MIC auditor who will perform the audit. The auditor will send a letter listing the records and documents you should submit. In some cases, the auditor will also explain why you are being audited. During the early phase of the audit, the auditor will set up an entrance conference.

Since auditors exercise great discretion when performing a desk or field audit, you need to have a qualified Los Angeles Medicaid audit lawyer from Spodek Law Group to assist you. Unlike RAC’s, MIC auditors don’t have a limit to the medical records they can request. After completing the audit, the auditor will prepare an audit report and share it with the California Medicaid agency to review and ensure that all Medicaid regulations are followed. The auditor will also issue you a copy of the report after which you will have a span of 30 days to either comment or submit more information.

License Penalties

It is common for the Medicaid Board to impose penalties against a licensed healthcare provider after the licensee has been sanctioned or audited by Medicaid. At this point, you need to have a lawyer who can defend you from unwarranted disciplinary action. After you have suffered sanctions or disciplinary action following administrative proceedings, your lawyer will apply the writs of mandate to pursue a judicial review of the action. A qualified lawyer will also combine the petition with a request for injunctive relief, for instance, a temporary restraining order to protect you. Although such petitions aren’t always granted, a request from an experienced attorney is likely to be approved.

Internet Prescription Penalties

Recently, the Board of Pharmacy has enforced regulations prohibiting pharmacists from filling prescriptions received via the internet. Pharmacies and pharmacists that are alleged to violate these laws can face huge fines, exceeding $1 million and, in some cases, over $10 million. The Medical Board of California also imposes additional fines on these healthcare providers.

These cases are often complicated due to the involvement of the DEA (Drug Enforcement Agency) since they involve the transportation of prescription drugs, which are categorized as controlled substances. In such a case, the pharmacist is at a higher risk for criminal prosecution. Developing technical and factual defenses is necessary in such cases.

How Can Spodek Law Group and Attorney Todd Spodek Help You?

At Spodek Law Group, we understand the gravity of the situation and how it can affect your practice. Our Medicaid audit lawyers will ensure that all your rights are protected, and we’ll stand by your side from the initial process in responding to the Medicaid auditors’ notice to appealing your case. Our team is well equipped to handle all aspects of the audit process, ensuring that you get the best representation possible.

We have a deep understanding of the law and the professionalism required to handle the legal situation. We have years of experience handling Medicaid audits and can provide personal anecdotes that share a story, which relates to an emotional response. Our team can rewrite the sentences to use emotionally charged words that show the firm has the experience to handle the legal situation.

If you have received a Medicaid audit notice, it’s crucial to talk to an experienced attorney. An audit can expose you to harsh administrative and financial penalties, including imprisonment, heavy fines, and forfeiture of your assets. With Spodek Law Group and Attorney Todd Spodek, you can rest assured that you’re in good hands. We will be with you every step of the way, ensuring that you receive the best representation possible.

H3: The Auditing Process

After being selected for a Medicaid audit, the auditing process can be complex and daunting. The Medicaid Integrity Contractor (MIC) auditor will perform the audit, sending you a letter that lists the records and documents you should submit. It’s important to pay close attention to this letter, as the auditor may explain why you’re being audited. During the early phase of the audit, the auditor will set up an entrance conference, making it crucial to have an experienced Medicaid audit lawyer on your side.

H4: How Spodek Law Group and Attorney Todd Spodek Can Help You in the Auditing Process

At Spodek Law Group, we understand the intricacies of the Medicaid auditing process. We’ll be with you every step of the way, from the initial process of responding to the Medicaid auditors’ notice to appealing your case. Our team will provide you with the best representation possible, ensuring that your rights are protected, and your case is handled professionally.

We’ll work closely with the auditor, ensuring that all Medicaid regulations are followed, and in the case of an audit report, we’ll issue a copy to you. You’ll have a span of 30 days to either comment or submit more information, giving you the best chance to prove your case. Our team has a deep understanding of the law and the experience to handle the legal situation, ensuring that you get the best representation possible.

H3: License Penalties

If you’re facing sanctions or disciplinary action after being audited by Medicaid, it’s crucial to have a qualified lawyer who can defend you. The Medicaid Board often imposes penalties against licensed healthcare providers after being audited, and it’s crucial to protect your rights.

H4: How Spodek Law Group and Attorney Todd Spodek Can Help You with License Penalties

At Spodek Law Group, we’ll be with you every step of the way, ensuring that your rights are protected. Our team will apply the writs of mandate to pursue a judicial review of the action and combine the petition with a request for injunctive relief, protecting you from any unwarranted disciplinary action. With our experience and expertise, we’ll give you the best chance of success, and ensure that you get the best representation possible.