“Finally Friday!” Extrapolation of Medical Necessity by the OIG

This session was recorded on Friday, June 21, 2013.

Today’s show is a walk down into the rabbit hole… the rabbit hole that is Extrapolation…  We look into a case where the OIG uses extrapolation to do some strange estimations of “possible” errors, but insists that the provider in question is liable for the claims that they truly on suspect are in error. Their use of extrapolation for medical necessity decisions is decidedly disturbing.

Recent articles about an OIG audit of a Nashville hospital has raised questions about the proper use of extrapolation and in particular, what are the legal implications of an OIG audit that calculates improper payments and issues a “suggested” payment amount. What would YOU do?

Hear from statistical expert Frank Cohen, of the Frank Cohen Group, as he describes how one might attack an extrapolation case, which he has done, successfully, on more than one occasion.

Video Recording

Audio Only - MP3
Click Here to Download an MP3 Audio Only version.

Handouts
Sorry no handouts today…

But we highly recommend the resources you can find on Frank Cohen’s website….

FrankCohenSite

Frank Cohen’s Website

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