Medicare Compliance & Reimbursement

"For every dollar they put into enforcement, the government receives multiple back, so it's just good business on the government's part to increase enforcement funding to stop fraud," explains Michael F. Schaff, Esq., with Wilentz, Goldman and Spitzer in Woodbridge, N.J."Practices have been leery about the increase in funding, but if you're doing things right, you don't have to worry," Schaff says.

Strategy: "Every practice should have appropriate compliance procedures in place and be careful what they do," Schaff says. Make sure your staff is properly trained and that you don't upcode or bill for unnecessary services, "because right now if you're an outlier (for instance, if you bill a disproportionate amount of level five E/M visits), that will cause the payer to look at you more carefully. Ensure that you properly document whatever services you perform, because even if you bill for the specific services you provide, if you don't document those services properly, it's as if you never performed those services and you could be in trouble."