Lexology March 19, 2025
Background
For healthcare providers in Connecticut, Medicare and Medicaid audits are an ever-present reality. Federal and state agencies actively review provider claims to identify billing errors, fraud and noncompliance, and an audit notice should never be ignored or minimized. One of the most concerning audit techniques is extrapolation, where findings from a small sample of claims are projected over a larger universe of claims—turning minor issues into massive overpayment demands. An audit can result in recoupments, fines, or even exclusion from government programs in cases where fraud is detected. To help you stay prepared, here is what every provider should know about these audits.
Medicaid Audits in Connecticut: State Scrutiny
Connecticut’s Medicaid program is overseen by the Department of Social...
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