Healthicity Blog

Nursing homes are facing a new level of scrutiny. Not just around billing or staffing, but around whether critical safety events are being captured, investigated, and reported.

Many organizations believe they are handling compliance issues effectively — until they have to prove it.

Each year, CPT^® updates bring shifts that ripple across coding, auditing, and revenue integrity teams—and 2026 is no exception. This year’s changes highlight ongoing expansion in virtual care, refinements in surgical reporting, and the continued evolution of immunization coding.

November 2025 saw many new additions to the HHS OIG Work Plan.  

In this month’s Deeper Than the Headlines, CJ Wolf breaks down a federal fraud case involving a physician who pled guilty to submitting false claims related to genetic testing. The doctor, a co-owner and advisor to a diagnostic lab in Georgia, conspired with others to generate medically unnecessary...

Auditing and monitoring are core pillars of any effective compliance program. But as regulatory expectations evolve and OIG findings become increasingly detailed, it’s more important than ever for compliance teams to ensure their audit plans are aligned with current risks.

Critical care isn’t confined to the ICU anymore.

Audit teams know the drill: spreadsheets, shared drives, version confusion, unclear findings, follow-ups lost in email, and reporting that takes longer than the audit itself.