As with any federal program, CMS has the authority to audit the reported data and the underlying source documentation. If these audits uncover evidence of false claims, fraud or abuse, CMS and the Inspector General can levy fines (treble damages) or even bar providers from participation in the Medicare program. The threshold of materiality is one cent.
If your practice is selected for audit, your practice has 45 calendar days to respond to the CMS request for data.
Here’s what you need to know in order to survive an audit…