Healthcare Audit Defense Attorney
“Routine audits” are becoming less routine and more common and aggressive. Whether stemming from insurance companies, the Texas State Medical & Dental Boards, Medicare and Medicaid programs, or the countless additional Texas licensing agencies. 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 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 analysis of your practice will highlight billing practices that may increase your chances for 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, all staff are properly trained, systems with checks and balance points are in place to help eliminate billing errors.
Billing and coding are scrutinized by elaborate programs with the latest live time algorithmics. 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)
Civil Monetary Penalties Law (CMPL)