The Physicians Advocacy Institute: helping physicians face medical audits.

Introduction The Physicians advocacy institute (Pai) is a not-for-profit 501(c)(6) advocacy organization established in 2006 with funds from settlement agreements in the multidistrict litigation (mDl) class action against major national for-profit health insurers. Pai’s board of Directors is comprised of Ceos of medical societies involved in the mDl and a physician who was a named plaintiff in that litigation. likewise, its Physicians advocacy liaison Committee is comprised of legal counsel to these medical societies. CSmS was a named plaintiff and critical player in the mDl litigation. as a result, CSmS executive vice President/Ceo matthew Katz serves on Pai’s board of Directors and CSmS general Counsel layne gakos serves on Pai’s Physicians’ advocacy liaison Committee. When it was formed, Pai’s mission was twofold: 1) to monitor and attempt to assure compliance with the mDl Settlement agreements and 2) to identify and address future health-plan practices that burden the ability of physicians to be fairly paid for their services. With the expiration of the last mDl Settlement agreement, Pai has now focused all of its attention towards the second part of its mission: ensuring the viability of physician practices. in all of its projects, Pai calls on the expertise of its board and Physicians advocacy liaison Committee and endeavors to respond to physician needs not currently met by other organizations. This article will focus on Pai projects geared towards ensuring that recovery audit Contractors (raC),* other governmental, and private payer audits are as transparent and fair as possible and providing physicians with the tools they need to prepare for and defend these audits.