Healthicity Blog

Compliance is complex. Managing your program shouldn’t be.

Physician group practices face mounting regulatory responsibilities, but many continue to overlook compliance blind spots that can carry major financial and reputational consequences.

For many healthcare practices, “incident-to” billing is a common strategy used to increase Medicare reimbursements.  It sounds like a smart revenue move. But without a clear understanding of the rules, it can also be a compliance landmine.

Every strong compliance program starts with the ability to identify and act on potential issues — but turning those reports into trackable, manageable actions can be where things start to fall apart.

For years, spreadsheets have been the go-to tool for compliance teams tracking 60-Day Rule adherence. But in today’s complex healthcare environment, manually updating spreadsheets just doesn’t cut it anymore. The risks are too high—missed deadlines, undetected overpayments, and noncompliance...

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The 60-day rule under the Affordable Care Act is one of the most important compliance regulations for healthcare providers accepting Medicare or Medicaid payments. It requires organizations to identify, report, and return any overpayments within 60 days of discovery. Failure to comply can lead to...

In November 2024, the OIG released its first-ever Industry Segment-Specific Compliance Program Guidance (ICPG), starting with Skilled Nursing Facilities and Nursing Facilities. This guidance highlights key compliance risks and reinforces the importance of resident safety and quality care.