Auditors from the U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) and the Recovery Audit Contractors (RACs) are using extrapolation on an increasing number of audits because it all but guarantees the demand for repayment being significantly higher than in the past. They win. Big time. Case in point: A $1.4 million overpayment estimate from Mount Sinai Health System in New York became a $42 million demand by the OIG simply by extrapolating from a sample of results.
Today, extrapolation is the most popular recovery tool in the RAC arsenal. Why? Because extrapolation can increase the overpayment demands on your facility by orders of magnitude. However, along with extrapolation comes a significant increase in the amount of error that is a part of the overpayment amount.
Knowing how to defend your facility against a bad extrapolation could save your facility millions of dollars in overpayments.
And that is why every compliance and audit manager should have a working understanding of how extrapolation works and how to defend against a bad one. This critically important RACmonitor webcast will cover the six components of extrapolation, explaining the good and bad of each one.
The following are essential learning objectives for this webcast...
- Understand the basic principles of sampling and extrapolation
- Review the CMS requirements for applying extrapolation to an audit
- Learn how to find out whether the 6 criteria have been met and when to challenge them
- Learn when to use the most effective calculation for point estimates
- Hear how others have mitigated financial damage through case examples