Healthicity Blog

Medicare audit reports are often treated as retrospective summaries, documents that explain what went wrong after the fact. But for organizations focused on strengthening their audit programs, they offer something far more valuable: a forward-looking view of risk.

The Department of Justice’s announcement of $6.8 billion in False Claims Act recoveries for fiscal year 2025 marks a historic high—and a clear message to healthcare organizations.

The OIG often advises healthcare organizations to “follow the money” when assessing compliance risk. That guidance applies just as well to the OIG itself.

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.

Leading health systems  are standardizing compliance and auditing -- find out how. 

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.

Behavioral health providers face a unique set of compliance challenges. From protecting patient privacy to managing sensitive documentation and ensuring ethical care delivery, the stakes are high. That’s why the Office of Inspector General’s (OIG) Seven Elements of an Effective Compliance Program...

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...