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.

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.

Each year, CPT^® updates bring shifts that ripple across coding, auditing, and revenue integrity teams—and 2026 is no exception. This year’s changes highlight ongoing expansion in virtual care, refinements in surgical reporting, and the continued evolution of immunization coding.

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.