Practice Groups →Health Care Law
Audits & Investigations
Receiving notice of a government audit or investigation is stressful, and the decisions you make early in the process matter.
Whether you are facing an OMIG audit, an inquiry from the New York State Department of Health, or a referral involving allegations of fraud, waste, or abuse, you need experienced counsel in your corner quickly.
We guide health care providers through government audits and investigations from start to finish. That includes preparing responses to audit findings, developing repayment and recoupment strategies, negotiating with agencies to reach defensible outcomes, and working through appeals when initial findings are incorrect. We also help organizations use the audit process as an opportunity to strengthen their compliance infrastructure so the same issues do not recur.
Our audit and investigation services include:
We assist providers from the moment an audit notice is received, helping them understand the scope of the review, preserve and organize records, and respond strategically rather than reactively. Early positioning often shapes the outcome of the audit and can significantly reduce recoupment exposure.
When audit findings are incorrect, overstated, or based on flawed sampling or legal theories, we challenge those determinations through rebuttals and administrative and court appeals. Our litigation background informs how we build defensible records and arguments at each stage of the process.
We help providers evaluate potential overpayments or compliance issues and determine whether self-disclosure is appropriate. When disclosure is warranted, we prepare submissions designed to limit scope, manage repayment exposure, and reduce the risk of follow-on enforcement actions.
We assist clients in analyzing alleged overpayments, including statistical sampling, look-back periods, and legal sufficiency of audit findings. We negotiate repayment terms and amounts with the goal of reaching resolutions that are financially and operationally manageable.
Following an audit or investigation, we work with providers to design and implement corrective action plans that address root causes rather than symptoms. The focus is on preventing recurrence of the issues that triggered scrutiny in the first place.
We work closely with billing experts, compliance consultants, and internal teams to ensure that legal strategy, operational fixes, and financial analysis are aligned. This integrated approach helps clients move forward confidently once an audit or investigation concludes.
Predictable options begin with a conversation.
Tell us what is in front of you. We will help you understand your options and what each one involves.