Wachler & Associates, P.C.: Successful Results Across A Wide Range of Audits
Our firm has defended thousands of Medicare, Medicaid, and third party payor audits and has developed successful strategies for substantially reducing overpayment demands. Our attorneys are industry leaders and have been highly successful defending Medicare audits on behalf of healthcare entities, providers and suppliers. Our firm prides itself on staying abreast of the newest laws and regulations affecting such audits and has demonstrated an ability to maintain a high rate of success in the Medicare appeals process. This is particularly significant given that the Medicare appeals process has undergone significant changes since 2005. Recent audits are no exception; we have obtained very successful results. For example:
- Our firm defended a Medicare audit of a physician requesting that the provider repay over $2.3 million. As a result of the hearing, the overpayment demand was reduced to $89,000, or just 3.5% of the original request.
- Our firm defended a Medicare audit of a physician requesting that the provider repay the Medicare program over $200,000. As a result of the Administrative Law Judge hearing, the overpayment demand was reduced to $0.
- Our firm defended a Medicare audit of a physician requesting that the provider repay the Medicare program over $2.5 million. As a result of the Administrative Law Judge hearing, the overpayment demand was reduced to $0.
- Our firm represented a provider group faced with a Medicare audit requesting that the group repay the Medicare program over $850,000. Following the Administrative Law Judge hearing, the overpayment demand was reduced to only $68.
- Our firm represented a hospice entity, which had been subject to an audit of its services provided to 17 beneficiaries. In that case, we received 14 favorable decisions on the record, without even the need for a hearing.
- Our firm currently represents a large health system that was subject to RAC auditing during the RAC demonstration program. Of the appeals we have filed to date on behalf of this organization, our success rate approximates 90 percent.
- Our firm currently represents a hospice entity that was subject to pre-payment review. To date, our law firm has been successful to return over $4 million to the entity, with very successful results. As a result of these successes, the hospice was removed from pre-payment review.
