Healthcare Audit Defense


Healthcare Audit Defense Attorney

“Routine audits” are becoming less routine, more common and more aggressive. Whether stemming from insurance companies, the Texas State Medical & Dental Boards, Medicare and Medicaid programs, or the countless additional Texas licensing agencies, it is imperative to respond. If you have become entangled in an audit our firm can help.

As a licensed dentist and practicing attorney, Dr. Hieu Huynh has a unique vantage point. As a practicing dentist in the trenches, a healthcare business owner for over two decades, and as a healthcare attorney, Dr. Huynh's rare insight and experience as the owner of a group of dental offices in southeast Texas provides him with a deep understanding of the business, compliance and legal aspects of a small healthcare business owner. Our firm has been successful in advocating for providers by fighting recoupment demands, EHR grant repayment demands, board licensing matters, employee/Texas Workforce Commission inquires, OSHA audits and more.

If you are already involved in an audit, it is crucial to engage in competent representation as soon as possible to help prevent any potential negative ramifications as well as increasing the likely hood of dismissal. Civil financial penalties as well as potential criminal charges are not the only concerning factors, your professional license and reputation are at stake

Medical and Dental Compliance and Audit Prevention

An ounce of prevention is worth a pound of cure. Of course, the best plan of action is ensuring you are in compliance before you are faced with an audit. As the saying goes, ‘hindsight is 20/20'.

We can help your practice by designing and implementing a training and compliance program. We have found that our clients have had great success with our training and compliance program in preventing inadvertent billing or coding errors before they happen. Our firm's deep data analysis of your practice will highlight billing practices that may increase your chances of being audited and help to find real world solutions to minimize such high-risk practices. We have helped many providers ensure that protocols and documentation are in compliance, that all staff are properly trained, and ensuring the systems are equip with checks and balance points to help eliminate billing errors. Billing and codes are scrutinized by elaborate programs with the latest live time algorithmic  Complex utilization statistics are now compiled in an instant. Your billing patterns are constantly being analyzed and compared to industry standards.

EHR Incentive Audits

Federal regulations require states to conduct audits of payments to eligible professionals (EP) and eligible hospitals (EH) participating in the Texas Medicaid Electronic Health Records (EHR) Incentive Program. The Health and Human Services Commission (HHSC) follows policies and procedures related to audit notifications and review of audit findings in accordance with Texas Administrative Code. HHSC contracts with an independent audit firm to conduct audits of Texas Medicaid EHR Incentive Program payments. The auditors will notify each EP and EH (provider) selected for a post payment audit. If audited, the provider must complete a questionnaire and supply auditable supporting documentation to verify that the provider met the federal and state requirements for receiving Texas Medicaid EHR Incentive Program payments. After completing the audit, the auditors will issue an Audit Results Notification Letter to inform the provider of the audit outcome and explain any audit deficiencies. Providers have a ten-day (10) period to submit additional information to the auditors to demonstrate remediation or otherwise resolve deficiencies cited in the Audit Results Notification Letter. This ten-day (10) remediation period is the last opportunity for the audited provider to add documentary evidence to their case file during the entire audit and review process. Our team of attorneys help guide you through the audit process and help protect your rights.

False Claims Act (FCA)
Anti-Kickback Statute (AKS)
Physician Self-Referral Law (Stark Law)
Exclusion Authorities
Civil Monetary Penalties Law (CMPL)
Stark Law

Medical, Nursing and Dental Board Defense

If you have received any complaint by any Texas Healthcare Board, such as the Texas Medical Board (TMB), the Texas Nursing Board (TNB), or the Texas Dental Board (TDB), we can help your defense and represent you throughout the entire process. All complaints begin by receiving a certified letter from the Board, typically investigating the standard of care. Respondents have ten (10) days of receipt to respond to the letter, following the requirements of business record affidavits and patient records. We can help you navigate the investigation and represent your defense. Dr. Huynh has extensive experience in defending healthcare professions against the Dental, Medical, and Nursing Boards of Texas. He will guide you through the entire process, from reviewing the concerns, analyzing the patient records and facts, drafting the response to the board, defend your license and reputation in front of the Board and protecting your rights. 

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Call us 713-622-1111 or email [email protected]

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Huynh & Huynh is located in Houston, Texas. Our mission is to serve as the primary resource for our clients' personal, financial, and business growth.