Policy & Regulatory Changes

Pulling Back the Curtain: Lessons from a OIG Risk Adjustment Audit

EDITOR’S NOTE: The author of this article used artificial intelligence (AI)-assisted tools in its composition, but all content, analysis, and conclusions were based on the author’s professional judgme...

Former Nurse Practitioner Pleads Guilty to Possessing Controlled Substances with the Intent to Unlawfully Distribute Them - Office of Inspector General (.gov)

Former Nurse Practitioner Pleads Guilty to Possessing Controlled Substances with the Intent to Unlawfully Distribute Them  Office of Inspector General (.gov)

Podiatrist and Pharmaceutical Sales Representative Sentenced in $3.2 Million Healthcare Fraud Conspiracy Involving Unlicensed Person Performing Skin Grafts - Office of Inspector General (.gov)

Podiatrist and Pharmaceutical Sales Representative Sentenced in $3.2 Million Healthcare Fraud Conspiracy Involving Unlicensed Person Performing Skin Grafts  Office of Inspector General (.gov)

Slidell Doctor Sentenced For $6.6 Million In Health Care Fraud - Office of Inspector General (.gov)

Slidell Doctor Sentenced For $6.6 Million In Health Care Fraud  Office of Inspector General (.gov)

ACA Stress Test: Four Key Takeaways from This Year’s Open Enrollment

ACA Stress Test: Four Key Takeaways from This Year’s Open Enrollment  MedCity News

Macomb County Dentist Charged with Racketeering in Massive Alleged Medicaid Fraud Scheme - Office of Inspector General (.gov)

Macomb County Dentist Charged with Racketeering in Massive Alleged Medicaid Fraud Scheme  Office of Inspector General (.gov)

Attorney General Bonta Dismantles Los Angeles Hospice Fraud Ring Responsible for $267 Million in Fraud, 21 Charged - Office of Inspector General (.gov)

Attorney General Bonta Dismantles Los Angeles Hospice Fraud Ring Responsible for $267 Million in Fraud, 21 Charged  Office of Inspector General (.gov)

The DOJ continues to come for healthcare fraud: What ASCs, physicians need to know

Acting U.S. Attorney General Todd Blanche launched the National Fraud Enforcement Division on April 7, consolidating the Justice Department’s fragmented fraud units into a single, centralized division...

Structuring Discounts Arrangements in Compliance with Federal Anti-Kickback Law: OIG’s Advisory Opinion 25-11

San Fernando Valley Clinic Operator Sentenced to 18 Years in Federal Prison for Role in Ring that Sold Illegal Opioid Prescriptions for Cash - Office of Inspector General (.gov)

San Fernando Valley Clinic Operator Sentenced to 18 Years in Federal Prison for Role in Ring that Sold Illegal Opioid Prescriptions for Cash  Office of Inspector General (.gov)