Compliance & Legal

Compliance risk in VBC is increasingly centering on data, AI governance, and operational controls: Innovaccer is positioning “governance-led AI” for population health and value-based care as health systems and ACOs face pressure to prove that predictive analytics, care-gap workflows, and risk stratification are auditable, unbiased, and compliant (Innovaccer AI governance in VBC). At the same time, HHS OIG enforcement activity underscores that Medicaid billing integrity and exclusion-screening failures remain live risks for provider networks, with actions involving alleged Wisconsin Medicaid fraud and Tennova Healthcare-Clarksville