CJ Wolf
Whether you’re a medical coder, auditor, or compliance professional, staying up to date on 2026 ICD-10-CM updates is crucial for accurate reporting and reducing claim denials.
CJ Wolf
The HHS OIG has added to their work plan an analysis of Medicare Advantage Enrollment. According to OIG, the Medicare Advantage program is vulnerable to schemes designed to increase Medicare Advantage organization (MAO) profits by improperly influencing enrollment. They explained that known...
CJ Wolf
According to the National Alliance on Mental Illness (NAMI)1, there has been a significant increase nationally in the number of individuals suffering from mental health conditions. Some of the numbers NAMI reports include the following:
CJ Wolf
Behavioral health compliance comes with its own unique challenges—and it can feel like the rules are always changing. To make it easier, we pulled together a set of resources that break down the latest updates, highlight enforcement trends, and share practical tips you can put to work right away.
CJ Wolf
Durable Medical Equipment
For decades compliance professionals have been reading Department of Justice press releases related to fraud, waste, and abuse involving durable medical equipment (DME). DME includes prosthetics, orthotics, and supplies (also known as DMEPOS).
CJ Wolf
Few coding modifiers have drawn as much scrutiny as modifier -25. Used to indicate a significant, separately identifiable evaluation and management (E/M) service on the same day as another procedure, modifier -25 has long been a point of focus for third-party payors and government enforcement...
CJ Wolf
The OIG added many items to its work plan in July 2025. Below we have summarized a few of these items most likely to affect health care provider organizations.
CJ Wolf
Government audits of hospital activities are plentiful. Is your hospital ready for such audits? Let’s take a look at some of the issues hospitals face from external government audits.
