Melissa Mohon to Lead National Organization Dedicated to Improving Regulatory Compliance and Quality Care for Medicare ...

For Medicare contract sponsors to remain viable, it's now necessary to perform a comprehensive Medicare program compliance review. Proposed rule changes may give CMS additional authority next year.

Workers' comp insurers can contest coverage without risking immediate double damages lawsuits, a Michigan appeals court ruled this week in a significant Medicare reimbursement case.

Last week, OIG’s Office of Audit Services released its latest report on Medicare Administrative Contractors’ (MACs) compliance with Medicare cost report oversight requirements. The report, which is ...

Lately, I’ve been thinking about something that is critically important but doesn’t get enough discussion among insurance and financial professionals: How do we effectively reach and engage potential ...

If you are a hospital or health system that owns and operates an accountable care organization (ACO) participating in the Medicare Shared Savings Program (MSSP), or if you are seeking to participate ...

While providers aren’t required to follow OIG recommendations, a compliance program based on their guidance can spare facilities future headaches, since ...

Recovery audit contractors and Medicare administrative contractors will coordinate activities in their hunt for overpayments to hospitals, according to a report by the Report on Medicare Compliance.

CMS has issued its latest Medicare Quarterly Provider Compliance Newsletter and it addresses areas including incorrect coding of tracheostomy and excisional debridement as a result of recovery audit ...

With agencies dueling to regulate nursing homes, aligning priorities for a strategic compliance program may be more challenging than ever.

Under the home health prospective payment system (PPS), the Centers for Medicare & Medicaid Services pays home health agencies (HHAs) a standardized payment for each 60-day episode of care that a ...

The Consolidated Appropriations Act, 2026, which was signed into law on February 3, 2026, includes a significant new requirement affecting ...