Healthicity Blog

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...

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:

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.

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).

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...

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.

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.

News of a Chicago physician's 10-year federal prison sentence for healthcare fraud made headlines earlier this month. The charges centered on claims submitted for procedures that were not medically necessary, with some performed without full patient consent. These actions led to consequences for...