Breaking down Medicare Compliance Reviews

By Catherine Boerner, JD, CHC

Catherine Boerner (cboerner@boernerconsultingllc.com) is President of Boerner Consulting, LLC in New Berlin, WI.

It can be helpful to inform the Compliance Executive Committee and/or the Compliance Operations Committee, at least quarterly, about the results of the OIG Medicare Compliance Reviews and how organizations are responding to and appealing these audits. Below are a few examples of how you can breakdown these reports for the discussion. A discussion about what the audit periods cover, how stratified random samples are chosen, and how the results are extrapolated may help enforce the need to ensure everyone is trained in these risk areas and controls are in place to reduce compliance risk.

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