Hospice Insights: The Law and Beyond

I Understood There Would Be No Math: Audits, Extrapolations, and a New Set of Rules

Episode Summary

Audits that employ statistical extrapolation can turn a handful of claim denials into a liability of hundreds of thousands or millions of dollars. After years of relative quiet, the statisticians are back. The Centers for Medicare and Medicaid Services (CMS) also modified the rules relating to extrapolation in audits. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki review the latest in extrapolation and how the new rules will affect audits going forward.

Episode Notes

Audits that employ statistical extrapolation can turn a handful of claim denials into a liability of hundreds of thousands or millions of dollars. After years of relative quiet, the statisticians are back. The Centers for Medicare and Medicaid Services (CMS) also modified the rules relating to extrapolation in audits. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki review the latest in extrapolation and how the new rules will affect audits going forward.