New Industry Segment-Specific Voluntary Compliance Program Guidance
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) has released the new industry Segment-Specific Voluntary
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DHS -Office of Inspector General
Nursing homes fail to report 43% of most serious falls: HHS
(By: Elizabeth Gregerson for Becker’s Hospital Review ) Nursing homes failed to report 43% of falls that resulted in major
Read MoreBilling for Remote Patient Monitoring in Medicare
In 2024, Medicare paid $536 million for remote patient monitoring, a 31 percent increase from 2023. Remote patient monitoring (RPM)
Read MoreMore Medicare patients leaving hospitals against medical advice
(By: Paige Twenter for Becker’s Hospital Review ) The rate of Medicare enrollees leaving acute care hospitals against medical advice
Read MorePrior Authorization Process Policies in Medicaid Managed Care: Findings from a Survey of State Medicaid Programs
(By Jada Raphael, Elizabeth Hinton, Aimee Lashbrook, and Kathleen Gifford for The Kaiser Family Foundation Published: Aug 07, 2025) Medicaid
Read MoreWatchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits
(By Fred Schulte for KFF Health News) A new federal watchdog audit is ratcheting up pressure on government officials to
Read MoreMedicare Advantage: Questionable Use of Health Risk Assessments Continues To Drive Up Payments to Plans by Billions
(Source - oig.hhs.gov) Medicare Advantage (MA) companies receive higher risk-adjusted payments from the Centers for Medicare & Medicaid Services (CMS)
Read MoreOIG to probe whether Medicare Advantage plans deny post-acute care
(By Rylee Wilson for Becker’s Hospital Review ) HHS’ Office of Inspector General will audit Medicare Advantage plans’ use of
Read MoreFeds to investigate integrated Part D plans, PBMs
(By Rylee Wilson for Becker’s Hospital Review ) HHS’ Office of Inspector General will investigate the impact of vertically integrated
Read More10 payers audited for Medicare Advantage overpayments in 2023
(By Rylee Wilson for Becker’s Hospital Review ) OIG audits found over $213 million in estimated Medicare Advantage overpayments in
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