Medicare & Medicaid Audit Defense

When your practice is targeted in a CMS audit, everything comes under scrutiny, including documentation, billing, compliance, and even your intent. The stakes are high, and the process can be overwhelming. We help you respond strategically and confidently, protecting your reputation and revenue.

Take control of the audit process.

If you’ve received an audit letter from a Medicare contractor—whether a UPIC, ZPIC, MAC, or as part of the CERT program—our attorneys guide you through each stage. We review the audit scope, identify potential pitfalls, and help you craft a response that is thorough, compliant, and protects your interests.

Many practices make the mistake of submitting records without understanding what auditors are really looking for. We help you spot issues before the auditor does, reducing the risk of penalties, overpayment demands, or post-audit clawbacks that can threaten your revenue and reputation.

Support beyond submission

CMS auditors often request supplemental batches of records or push deadlines that feel impossible. We communicate directly with the auditor on your behalf, push back on overreaches, and ensure your practice isn’t unfairly penalized. If the audit results in extrapolated findings or a repayment demand, we advise on appeal strategies and negotiate with the payor when appropriate.

Proactive reviews to reduce risk

We also help practices reduce their audit risk by conducting internal reviews modeled on real audit methods. We’ll examine your records for compliance with CMS billing and documentation requirements and identify gaps that could trigger auditor scrutiny down the road.

Facing a Medicare or Medicaid audit? Schedule a consultation to protect your practice.

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