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Medicare Compliance & Reimbursement

BEWARE:

MICs Can Involve Medicare, Trigger Fraud And Abuse Investigations

Published on Mon Nov 09, 2009

4 strategies help you navigate MIC-related payment and compliance woes. If you think the Recovery Audit Contractors (RACs) are bad, you may not yet have heard about the Medicaid Integrity Contractors (MICs) who are already auditing hospitals, skilled nursing facilities, pharmacies, and other providers in some states. Although MICs are focused on Medicaid, they may intersect with Medicare, and could also pave the way for major compliance headaches -- in other words, prepare for trouble ahead. "Absolutely, I think we'll see cross-referrals between the MICs and Medicare," predicts attorney Paula Sanders, a partner with Post & Schell in Harrisburg, Pa. And unlike the RACs, which are paid on a contingency basis, the MICs are "much more narrowly focused on fraud, abuse and waste," Sanders warns. In addition, "the MICs will be working more closely with the OIG and Department of Justice." The good news: The following combo of strategies can [...]
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