Healthicity Blog

The Office of Inspector General (OIG) has released its long-awaited Industry Segment-Specific Compliance Program Guidance (ICPG) for Medicare Advantage (MA), offering a clearer picture of where regulators are focusing their attention and what organizations should be prepared to address.

Telehealth felt simple during the public health emergency (PHE). It wasn’t. We were operating under temporary flexibilities that masked how complex telehealth really is under Medicare statute. In our newest Compliance Conversations, CJ Wolf talks with Keisha Wilson, founder of KW Advanced...

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...

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).

An eye care organization in Pennsylvania recently agreed to pay $790,000 to resolve allegations of submitting improper Evaluation & Management (E&M) claims alongside bilateral eye injections. The violations, which occurred between 2018 and 2025, involved billing for same-day services in a way that...

The OIG added four items to its work plan in May 2025. Compliance professionals should be aware of the issues and assess their own organization to determine if the new Work Plan items affect them.

Senior Medicare Patrol Projects

In 1997, a recommendation in a congressional committee associated with legislation created an initiative involving seniors’ efforts to prevent Medicare fraud, waste and abuse. The efforts are formalized through the Administration for Community Living's Senior...

The OIG added multiple Work Plan items in February 2025. Let’s take a closer look at the items that may affect your organization.