How to protect your healthcare organizations’ integrity*
Healthcare organizations confronted by an investigation face many potential challenges: disruption to the business, strained relationships with regulators, potentially significant repayments as well as civil and criminal liability. With the stakes this high, healthcare organizations need to be well prepared to address issues of fraud, abuse, regulatory noncompliance and government investigations.
If this is your situation
- You are under federal or state enforcement agency investigation
- You need help gathering intelligence, preparing for arbitration, mediation or trial
- You need objective expert witnesses to support litigation
- You want to conduct an investigation into alleged fraud or abuse
How PricewaterhouseCoopers can help you
PricewaterhouseCoopers professionals combine investigative experience and techniques with deep industry knowledge to assist companies and their counsel during investigations instigated by the Department of Justice (DOJ), Office of the Inspector General and other state enforcement agencies, as well as through Qui Tam actions. Experienced in all phases of the internal investigative process, our interdisciplinary teams evaluate and help companies solve complex healthcare fraud issues, as well as actively assist counsel develop investigative strategies.
Services we provide include the following:
- Computer forensics, data acquisition and analysis
- Electronic evidence recovery
- Forensic accounting analysis
- Individual and corporate background checks
- Asset identification and recovery
- Witness identification, assessment and interviewing
- Medical record and documentation reviews
- Reimbursement process evaluation
- Negotiation support
- Regulatory research
- Research and analysis of industry best practices
- Risk quantification
- Scope analysis and support
- Statistical sampling design, modeling and extrapolation
- Corporate Identity Agreement negotiation and implementation
- Remediation and internal control assessments
