2019 Compliance Institute (CI)

Statistical Sampling in Healthcare Audits and Investigations

  • Statistical Sampling in Healthcare Audits and Investigations

    Michael Holper, Senior Vice President, Compliance and Audit Services, Trinity Health. Stefan Boedeker, Managing Director, Berkley Research Group, LLC.

    April 9, 2019

    • Discuss increasing use of statistical sampling and extrapolation of overpayment liabilities by federal and state audit contractors, regulators, and commercial payers

    • Discuss the fundamentals of proper statistical sampling, how to draw reliable conclusions from a sample to the underlying universe of claims, and statistical sampling of healthcare claims by regulators and third-party auditors

    • Discuss experiences in defending healthcare providers against the use of flawed statistical sampling and extrapolation models, including experience in pursuing available administrative appeals

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