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We've Moved! Coding Leader is now Healthcare Training Leader. Visit us at We've Moved! Coding Leader is now Healthcare Training Leader. Visit us at

Stay Off of CMS’ Audit List

The number of physician practices being audited each year continues to rise. As a result, more and more providers committing fraud, or just making mistakes, are being identified and required to pay massive penalties or have even been sentenced to jail time.   In many instances, the violation wasn’t intentional, but because they had no way to identify and rectify their mistakes, they were left dealing with the serious consequences.

CMS and other federal offices are intently watching, just waiting for you to slip up. They have vowed to Congress to root out and reduce Medicare and Medicaid fraud to help trim the federal budget.  So, if you’re doing something wrong, even by accident, you could end up in serious financial and legal trouble.  In fact, in 2016 the OIG recouped $2.5 BILLION in healthcare fraud judgements and settlements from practices just like yours.

The only way to stay off of audit radars is to have a process in place that allows you to identify and remedy possible compliance violations.  That’s where having a compliance plan comes in. And, should you get audited, having a current plan in place shows you are at least trying to be compliant vs. willfully committing fraud. 

Significantly Reduce Your Risk

Let’s face it, no one WANTS to create and maintain a compliance program for their practice. But if you see Medicare or Medicaid patients, you really have no choice.

Without a compliance plan, your chances of getting caught violating the False Claims Act, HIPAA, Stark, the anti-kickback rule, or other relevant laws goes through the roof. Individually, each one of these regulations are complex, and each one has numerous ways to trip you up. Together, your chances of remaining compliant without a compliance plan in place are seriously reduced.

There is help available for you. Expert, Kelly Grahovac, a Senior Consultant for the Van Halem Group, has an online training session about how to more easily and efficiently implement and manage a compliance plan in your practice.  The online session will take you through the 7 elements of a good compliance. You’ll learn about the best ways to implement your plan, and about how to identify your biggest risk areas.  Learn more about this online training.