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By Robert J. Milligan, originally published in Round-Up, Maricopa County Medical Society (July 2013)
The complexity of physician documentation, billing and coding requirements, and some recent statutory and judicial pronouncements, create significant risks for physician practices that conduct provider audits. The adverse consequences of failing to conduct audits, and a looming requirement for the performance of audits, make it likely that all practices that participate in Medicare will be conducting provider audits in the not too distant future. This article discusses the unhappy confluence of these forces, as illuminated by a recent federal District Court decision, and offers some thoughts about how to plan for dealing with the issues.