Healthicity Blog

Every year, healthcare compliance officers face the same challenge: predicting where federal scrutiny is headed before it reaches their organization. The OIG Work Plan 2026 gives compliance teams a meaningful head start. It outlines where the Health and Human Services (HHS) Office of Inspector...

The Inspector General of HHS has warned the healthcare compliance community that reimbursement methodologies associated with Medicare Advantage would be a top priority. Included in these efforts is an enhanced focus on Hierarchical Condition Categories (HCC) and risk adjustment.

When the Affordable Care Act was passed in 2010, it included a section (1343, to be exact)

Providers attend years of rigorous school, followed by multiple years of residency and fellowship programs

While the ongoing public health emergency continues to place a significant toll on our entire healthcare system,

Coding or auditing a record for Risk Adjustment can confuse even the most experienced professionals.

What is Risk Adjustment Coding?

As reimbursements shift from fee-for-service to value-based payments, the need for better risk adjustment audit tools are on the rise.