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a group of medical professionals in a hospital

Preventing Medicare fraud and abuse requires risk-based planning, auditing, documentation, reporting, investigation, and corrective action tracking. Organizations must maintain consistent oversight, monitor trends, and document compliance activities to demonstrate accountability and reduce...

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Reducing Audit Risk in Ophthalmology and Optometry - eBrief

Eye services remain a consistent area of focus for the OIG, with recent audit activity highlighting patterns that can quickly turn into repayment exposure: E/M services billed on the same day as intravitreal injections, high-level nursing facility E/M services billed by optometrists, and diagnostic...

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Understanding the OIG’s New Medicare Advantage Compliance Guidance - eBrief

The long-awaited Medicare Advantage Industry Segment-Specific Compliance Program Guidance (ICPG) has recently been released by the HHS OIG. It serves as an updated, voluntary resource intended to help Medicare Advantage Organizations (MAOs) and other Medicare Advantage Parties or “MA Parties”...

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