Healthicity Blog

As artificial intelligence becomes more embedded in healthcare operations, state-level regulation is evolving just as quickly. For organizations operating across multiple states, that means navigating not just one set of rules—but several, each with its own expectations, definitions, and...

Karl Pearson said it best: "That which is measured improves; that which is measured and reported improves exponentially."

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 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.

Eye and vision services continue to draw close attention from the Office of Inspector General—and the trend isn’t slowing down.

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.

Each year, HCPCS Level II codes are updated to reflect changes in clinical practice, technology, and reimbursement policy, and 2026 is no exception. New, revised, and deleted codes can directly impact how services are reported, reimbursed, and audited.

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