Program Integrity: The Wave of Medicare’s Future, in American Institute of CPAs Healthcare Fraud’s Newsletter

Daniel Gospin, an Associate in the Health Care and Life Sciences practice, in the Houston office, and Amy Lerman, an Associate in the Health Care and Life Sciences practice, in the Washington, DC, office, cowrote an article titled "Program Integrity: The Wave of Medicare's Future."

Following is an excerpt:

Every health care advisor should know that the government is on the program integrity warpath! In fiscal year 2011, Medicare Recovery Audit Contractors (RACs) recovered $797 million in Medicare overpayments. Based on program integrity activities in the early part of 2012, the government appears to be continuing its focus on auditing, investigating and prosecuting fraud and excluding health care providers from coverage or reimbursement. As such, RACs and their contractor counterparts, most notably the Zone Program Integrity Contractors (ZPICs), will be key instruments in the government's fight against health care fraud.