New York Healthcare Audit Defense Lawyer

Skilled Healthcare Audit Defense Attorney in New York, NY

Healthcare providers in New York may be subject to audits, reviews, and other measures by government agencies and private insurance companies. Even when these actions are simply called “reviews,” they can carry significant consequences for physicians, medical practices, and healthcare organizations. If you are facing an audit or want to make sure your practice is ready for one, it’s crucial to find an experienced New York healthcare audit defense lawyer.

Dedicated Audit Defense From a Trusted New York Law Firm

Whether your medical practice is located in Brooklyn Heights, Lower East Side, or elsewhere in New York, the dedicated audit attorneys at Weiss Zarett Brofman Sonnenklar & Levy, P.C., can provide you with the trusted support your case deserves. Our law firm is based in New Hyde Park, having grown from a mom-and-pop firm due to our long record of success in complex cases, including audits, for clients throughout New York and New Jersey.

When you work with our dedicated audit defense lawyers, you gain support from skilled advocates who understand how audits and reviews must be handled. By entrusting our lawyers to manage your case, you can greatly reduce the stress and distractions that come with the auditing process. You can trust Weiss Zarett Brofman Sonnenklar & Levy, P.C., to provide your healthcare practice with the focused support it deserves. 

Common Triggers for Healthcare Audits

The Health and Human Services Office of Inspector General reported more than $7.13 billion in expected recoveries and receivables resulting from investigations and audits during FY 2024, demonstrating a continued focus on healthcare oversight and enforcement.

Healthcare audits can be triggered for many reasons. Unusual billing patterns, coding discrepancies, documentation deficiencies, high utilization rates, and reimbursement claims that differ from industry norms may draw scrutiny from government agencies or insurance payors.

Audits may also be initiated due to patient complaints, whistleblower allegations, data breaches, or reports that suggest possible violations of healthcare regulations or unlawful billing. In some cases, providers are selected at random as part of ongoing oversight efforts.  

Concerns about Medicaid fraud drive ongoing reviews and audits. In FY 2024, enforcement actions led to $407 million in civil recoveries, along with 493 civil settlements and judgments. Audits can also reduce the occurrence of data breaches that compromise confidential patient information. In 2024, the Office for Civil Rights received 663 reports of data breaches that affected 500 or more individuals. 

Possible Penalties and Consequences of an Audit

A healthcare audit can have significant consequences for physicians, medical practices, and healthcare organizations. If auditors identify billing errors, documentation deficiencies, or regulatory violations, providers may face demands for repayment, financial penalties, and possible increased oversight from government agencies. Insurance companies may increase their scrutiny for years to come. 

Audits can disrupt daily operations by requiring providers to devote substantial time and resources to responding to document requests and inquiries. Addressing audit concerns promptly can help healthcare providers protect their practices and reputations. 

How Weiss Zarett Brofman Sonnenklar & Levy, P.C., Can Protect Your Interests?

If you have received notification that you are undergoing a review of your Medicare records or other documentation, Weiss Zarett Brofman Sonnenklar & Levy, P.C., can represent you through the review or audit process so your rights and interests can be protected from start to finish. 

Our lawyers understand the uncertainty that comes with these types of notifications, and we can begin by meeting with you to explain your options, along with the protections and services we can provide throughout the process. 

Our lawyers can:

• Review the audit notice.
• Manage communications with the auditors on your behalf.
• Prepare responses.
• Evaluate your billing and documentation to anticipate potential issues.
• Advise you on the right strategies as the process moves forward.

If an audit results in repayment demands, payor disputes, regulatory inquiries, or disciplinary concerns, our legal team can continue representing you as those matters are properly addressed. Complex cases could lead to administrative proceedings and other measures, which is why legal support from the outset is key to protecting your medical practice from adverse outcomes. 

Can My Healthcare Practice Prepare for Future Audits?

Yes. While no healthcare provider can eliminate the possibility of an audit, certain measures can reduce risk and improve preparedness, such as: 

• Maintaining accurate patient records
• Implementing strong compliance policies
• Conducting internal reviews
• Making sure that billing and coding practices are consistent with applicable regulations

All these can identify potential issues before they attract scrutiny. 

Healthcare providers should also remain informed about changes to Medicare, Medicaid, HIPAA, and other regulatory requirements. An experienced healthcare lawyer or law firm can further strengthen compliance efforts. They can also potentially reduce the risk that you are audited or experience harmful outcomes in any future audits. 

Why You Should Hire a Healthcare Audit Defense Lawyer?

Facing an audit can be a stressful experience, full of uncertainty about what comes next and worries about the future of your medical practice. When you hire a healthcare audit defense lawyer, you gain support from an experienced New York healthcare audit defense attorney who understands the state’s healthcare audit laws and how to protect your interests at every step. 

A New York healthcare audit defense attorney can explain the steps involved in an audit and help you prepare your healthcare audit defense case for review. If questions arise about business practices or bookkeeping, your lawyer can manage communications with the auditor so there are no misunderstandings that could lead to further scrutiny. 

Protect Your Healthcare Business by Hiring Weiss Zarett Brofman Sonnenklar & Levy, P.C.

The outcome of an audit or review can have significant implications for your healthcare business. When you work with Weiss Zarett Brofman Sonnenklar & Levy, P.C., you gain steady support from a law firm that understands the auditing process and how to protect the interests of clients throughout their cases. 

Our law firm is based in Long Island, so we understand the needs of the local medical community and state laws. Whether you are being reviewed by a government agency, an insurance carrier, or another party, our legal team can provide you with trusted support and guidance. Start the process by contacting our office today.