Benefit/Program Integrity Engagement Team

CSRF

“We are at the forefront of initiatives such as health care service innovation, meaningful use audits of electronic health records, payment error rate measurement, and a myriad of opportunities to assist clients identify and recover inappropriately paid claims. Harnessing the skills, talent, and experience of our team, we are confident that Myers and Stauffer can truly make a difference.” Chuck Smith, CPA and member and Ryan Farrell, CFE and principal (partners-in-charge of the Benefit/Program Integrity Team)

Who We Are

The benefit/program integrity (BPI) engagement team is focused on protecting the integrity of Medicaid payments, processes and systems. We specialize in providing, risk assessment, error rate measurement, loss prevention, and specialized auditing services to support public health care and social service agencies. BPI service offerings are based on three responsibility areas: improving the quality and efficiency of health care, preventing fraud, waste, and abuse, and recovering inappropriately made payments. Myers and Stauffer is not a typical accounting firm or government services contractor. We are a client focused, data driven, value oriented firm actively engaged in the environmental and regulatory challenges faced by our clients.

In addition to certified public accountants, the BPI team includes certified fraud examiners, health care policy and reimbursement specialists, attorneys, medical directors, professional coders, registered nurses, pharmacists, dentists, managed care specialists, Medicaid eligibility auditors, physician consultants, statistical consultants, financial analysts and computer information systems professionals. We have developed a highly skilled and experienced team of professionals with backgrounds in settings such as Medicaid agencies, offices of inspector general, fiscal agent contractors, social services programs, Medicaid Fraud Control Unit, health plans, hospitals, pharmacies, and the Centers for Medicare & Medicaid Services.

Selected Clients
  1. Alaska Department of Health and Social Services
  2. Colorado Department of Health Care Policy and Financing
  3. Georgia Department of Community Health
  4. Hawaii Department of Human Services
  5. Indiana Family & Social Services Administration
  6. Louisiana Department of Health and Hospitals
  7. Michigan Department of Community Health
  8. Texas Department of Information Resources

What We do

Through our benefit/program integrity services, Myers and Stauffer is able to assist our government health care clients develop, maintain and execute organizational compliance plans designed to hold providers, clients, systems and vendors accountable. The BPI loss prevention, auditing, and recovery services have prevented unnecessary program expenditures and identified millions of dollars in inappropriate payments. We have performed eligibility audits and analyses, and performed data analytics that help our client’s direct scarce health care funding to achieve their health care objectives. We are trusted partner for a strong approach to program integrity.

Where We're Headed

Myers and Stauffer is recognized as the national leader in supporting states with emerging initiatives. We are often asked to present at national conferences and workshops, and many of our protocols are recognized as the standard by which others are compared. With the population of the United States growing, health care costs increasing at rates several times inflation and funding scarcer today, Myers and Stauffer will remain at the forefront of helping our clients achieve their programmatic objectives.

Learn more about our BPI services!