Compliance
Expert articles and analysis related to compliance.
AI Summary — Last 30 Days
In the last 30 days, compliance scrutiny within Medicare Advantage programs has intensified, signaling a structural shift toward more rigorous oversight as detailed in multiple audits released by the Office of Inspector General (OIG). Key findings have revealed potential noncompliance risks for chronic care management services and specific diagnosis codes submitted by major plans like Gateway Health Plan and Blue Cross and Blue Shield of Alabama, emphasizing the urgent need for healthcare executives to enhance their compliance programs to mitigate risks associated with Medicare reimbursements. Furthermore, the recent release of compliance program guidance by the OIG underscores the critical importance of adherence to CMS directives as the landscape evolves from the previous administration's policies, necessitating proactive strategic adjustments from health systems and ACOs to align with compliance expectations in 2026 and beyond.
Related Articles
Health Care Compliance in 2026: What Compliance Leaders Need to Know
Health Care Compliance in 2026: What Compliance Leaders Need to Know Foley & Lardner LLP
Physicians face 'greater scrutiny, less margin for error' in 2026, compliance expert warns
Physicians face 'greater scrutiny, less margin for error' in 2026, compliance expert warns Medical Economics
Compliance for the Inpatient Psychiatric Facility (IPF-PPS): Minimizing Federal Audit Findings by Strengthening Best Practices
Compliance for the Inpatient Psychiatric Facility (IPF-PPS): Minimizing Federal Audit Findings by Strengthening Best Practices MedLearn Publishing
Medicare Advantage Industry Segment-Specific Compliance Program Guidance Issued
Practice Compliance in 2026: Regulatory Updates, Enforcement Trends, and Leadership Priorities
Practice Compliance in 2026: Regulatory Updates, Enforcement Trends, and Leadership Priorities Medical Group Management Association - MGMA
Crackdown on Medicaid and Medicare fraud means health systems need to prepare for heightened compliance scrutiny
Crackdown on Medicaid and Medicare fraud means health systems need to prepare for heightened compliance scrutiny Chartis
Seven Hills Health and Rehabilitation Center Agreed to Pay $167,000 for Allegedly Violating the Civil Monetary Penalties Law by Employing an Excluded Individual - Office of Inspector General (.gov)
Seven Hills Health and Rehabilitation Center Agreed to Pay $167,000 for Allegedly Violating the Civil Monetary Penalties Law by Employing an Excluded Individual Office of Inspector General (.gov)
The hidden toll of physician regulatory investigations
I have spent my career believing in systems. As physicians, we are trained to trust oversight. We are taught that regulatory bodies exist to protect patients, maintain standards, and intervene when ca...
The Evolving Landscape of Privacy and Cybersecurity: Essential Strategies for Legal and Compliance Professionals
The Evolving Landscape of Privacy and Cybersecurity: Essential Strategies for Legal and Compliance Professionals MedCity News
Epic flags improper access to UPMC records
Epic flags improper access to UPMC records - Becker's Hospital Review Becker's Hospital Review