Newsletter August 2013


Since October 2009, thousands of health care providers all over the country have been audited by the Centers for Medicare and Medicaid Services (CMS), resulting in $3.9 billion in recouped monies. In 2012 alone, Medicare took back approximately $2.3 million dollars after audits.

There are a variety of reasons that providers are audited by CMS. Medical necessity and coverage; coding, billing, and documentation issues; OSHA safety requirements; and HIPAA and HITECH violations are among the most common. At Karen McKeithen Schaede Attorney at Law, PLLC we are well versed in managing an audit. We guide you through every step, from filing the necessary appeals in the required time periods to reviewing records and negotiating deadlines, and, finally, to assisting with any hearings.

With so much at stake, it is imperative to hire an experienced attorney to assist in navigating the audit process. Call us the minute you receive notification of an audit. Don’t wait until it is too late!


Karen McKeithen Schaede Attorney at Law, PLLC

Changes in NC Medicaid Claims Processing

On July 1, 2013 a much anticipated change will take place in the North Carolina Medicaid system when the state’s 34-year-old claims processing computer system, known as Legacy, will be retired and replaced by the new system, NC Tracks.

Read On

HIPAA Allows for Disclosures in Certain Situations

The US Department of Health and Human Services recognizes that medical providers play a vital role in protecting the general public. There is information that is only available to providers, and they have a responsibility to share that information with the appropriate officials if a patient presents the threat of danger to themselves or others. There are circumstances when HIPAA does allow for the release of PHI without patient authorization.

Read On