Healthicity Blog

It is probably not intentional, but it sure seems like there is a theme to many of the U.S. Department of Health and Human Services Office of Inspector General (OIG) Work Plan items added in October 2023. 

Traditionally, as the calendar year approaches its end, many compliance programs evaluate their annual audit plan to assess its effectiveness and revise the plan as needed for the following year. Some compliance programs may do this at other times of the year. When it happens is not as essential as...

The OIG and the health care community share the goal of protecting patients from harm, which is why the OIG created new Adverse Events toolkits. These toolkits aim to advance patient safety through a discussion of methodological considerations when designing studies about patient harm and by...

It’s Halloween time and things can be scary. There are times when compliance can be scary too.

It's that time of year again – compliance programs are putting the finishing touches on their annual audit plan for the year ahead. Wrangling those fresh and familiar compliance risks is like a puzzle – you've got to be organized and clever to piece together a winning plan.

Medicare Advantage Compliance Under the Spotlight: Lessons from Cigna's $172 Million Settlement

$172 million is a lot of money. It's also the amount that the Cigna Group recently agreed to pay to resolve allegations it violated the False Claims Act in relation to its Medicare Advantage (MA) plan...

The Inspector General of HHS has warned the healthcare compliance community that reimbursement methodologies associated with Medicare Advantage would be a top priority. Included in these efforts is an enhanced focus on Hierarchical Condition Categories (HCC) and risk adjustment.

While the OIG didn’t add a high number of items to its Work Plan in September 2023, the updates it did make are critical.