CMS UPIC Compliance Audits

Comprehensive Pain Solutions

Medicare providers are often surprised by CMS UPIC Compliance Audits that investigate improper payments on a consistent basis. The CMS Program Integrity unit employs numerous auditors and contractors which can interrupt a providers’ financial stability, and challenge compliance programs at a serious level.

Such was the case with Nashville-based Comprehensive Pain Solutions – a multi-state pain management practice that received a Medicare UPIC compliance audit and an alleged $27M overpayment for potential improper claims payments and documentation errors. As the government moved to quickly begin recoupment, the practice quickly realized the crippling financial impacts, which could ultimately lead to bankruptcy.

Armory Hill Advocates was engaged by CPS to incorporate a legal and lobbying strategy. Armory Hill successfully worked with the Alabama Governor’s office, the southeast regional Medicare Administrative Contractor (MAC), the regional Qualified Medicare Contractor (QIC), the Tennessee Congressional Delegation, and CMS Program Integrity senior management. Ultimately, Armory Hill was successful in overturning of the $27 M judgment – within 6 months – saving over 300 jobs in the greater Nashville area.

comprehensive pain solutions, CMS UPIC Compliance Audits

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