Covid-19 Fraud Investigations Continue to Rise
The unprecedented COVID-19 pandemic brought never seen response from the Federal, State and Commercial payors in the detection, treatment and care of COVID-19. These un-paralleled level of payments to providers has brought never seen levels of Fraud, Waste and Abuse. Even the most compliant providers can find themselves on the wrong side of an over aggressive investigator, auditor or prosecutor and find themselves fighting for their practice, business or in many cases their freedom. Medilytix has consulted in cases of civil fraud investigations, HRSA audits, FCA/CID’s as well as criminal investigations. The underlying theme in many of these cases was the Government’s misinterpretation of provider guidance for services rendered during the pandemic or inaccurate data extrapolation. Our experience in providing litigation support and analytics has occured in the following modalities:
- Emergent/Urgent Care
- Clinical Laboratory/Diagnostic Testing
- Hospitals
- Primary Care
- Nursing Home/Assisted Living Facilities
Medilytix is posed to assist attorneys in all phases of Federal, State and Commercial payor audits and investigation by identifying and exposing erroneous interpretation of payor guidelines, audit/random sampling/extrapolation and billing/coding so your team can aggressively defend against unfair actions resulting from the services rendered during the COVID-19 pandemic.
