AI, Algorithms, and Extrapolations in Audit Defense

This session will provide an overview of the current federal fraud, waste, and abuse landscape and explain how initiatives from CMS influence day-to-day supplier operations. Attendees will gain a better understanding of recent enforcement trends, emerging compliance expectations, and practical steps to help reduce risk while maintaining compliance in an increasingly complex regulatory environment.

This presentation provides a comprehensive, practical exploration of the audit and compliance landscape for DMEPOS suppliers. Attendees will gain a clear understanding of current regulatory expectations, high‑risk operational areas, and the evolving oversight environment driven by CMS, Medicare contractors, accreditation bodies, and the OIG.

Through real‑world examples, the presentation equips DMEPOS leaders, compliance officers, and operational teams to strengthen internal controls, reduce denial risk, and build a proactive compliance culture. Topics include:

• Key regulatory requirements for DMEPOS suppliers
• Common audit triggers and high‑risk documentation areas
• How to prepare for contractor audits
• Strategies for internal monitoring and self‑auditing
• Effective corrective action planning and root‑cause analysis

By the end of the session, attendees will walk away with practical tools, checklists, and strategies to enhance audit readiness, protect revenue, and ensure organizational compliance across all DMEPOS operations.

This session will focus on the most cutting-edge use and abuses of AI and algorithimic software tools and extrapolations by payors and teach suppliers how to defend and prevent these types of audits. This session will also cover current litigation on key legal issues and developments in the laws surrounding the use of AI and algorithimic tools and sampling and extrapolation.