Compliance & Legal Risk
Expert articles and analysis related to compliance & legal risk.
AI Summary — Last 30 Days
Over the past 30 days, compliance and legal risk in value-based care has intensified, driven by heightened federal scrutiny over Medicare Advantage risk adjustment practices and payment integrity alignment. The Office of Inspector General (OIG) released new compliance guidance for Medicare Advantage organizations and published audits targeting diagnosis coding and provider documentation, placing pressure on health systems and ACOs to strengthen their internal controls and audit readiness [OIG Releases New Compliance Program Guidance for Medicare Advantage Organizations, [Medicare Advantage Compliance Audit of Specific Diagnosis Codes](https://news.google.com/rss/articles/CBMi6gFBVV95cUxQMVR1S1BYQjBhQk1RR1NsSGZfYUx2ZHJLNDlYWWQzbU9Tcl9ZX0llRnp2YXF
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What is the correct coding approach when iliac atherectomy and angioplasty and/or stent placement are performed in the same leg through the same access site?
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When is modifier 25 applicable?
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Under what conditions can we bill for 94640 and 94664 on the same date of service?
AI is great, but compliance needs you
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HL Shorts: The CFO Mindset Shift on Compliance
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When in Doubt, Ask – RACmonitor
Sometimes you want to be contacted by the US Department of Health and Human Services (HHS) Office of Inspector General (OIG). Â I realize that sounds totally counterintuitive. I mean, who wants to hav...