decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Civil Money Penalties / Statistical sampling
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Article Overview
This premium article covers the use of statistical sampling in civil money penalty cases involving the OIG and discusses the notice and hearing implications when sampling underlies an allegation. It is relevant to compliance professionals, auditors, billing and coding staff, healthcare attorneys, and providers who need to understand the general framework for sampling-based cases and appeals.
Why This Topic Matters
Organizations facing government enforcement actions may need to understand how sampling can shape allegations, evidentiary burdens, and administrative review. The article helps readers recognize the regulatory context and the type of procedural information that may be required when sampling is used.
What You Will Learn
- How statistical sampling is used in civil money penalty matters
- What type of sampling information is included in notice to a provider
- How sampling-related evidence may be presented in an administrative hearing
- How burdens of proof and rebuttal may arise in a sampling-based case
Who Should Read This
- Compliance professionals
- Healthcare attorneys
- Billing and coding staff
- Auditors
- Providers and practice administrators
Codes Discussed
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