The Office of Inspector General (OIG) published its semiannual report to Congress. The latest version summarized key oversight activities conducted between October 1, 2025, and March 31, 2026. The report informs Health and...Read More »
The Office of Inspector General (OIG) conducted an audit of Medicare Advantage (MA) organizations because some diagnoses are at a higher risk for being miscoded, which may result in overpayments from CMS. The audit is part of a larger series of audits in which we are reviewing the accuracy of...Read More »
After releasing its General Compliance Program Guidance in 2023, the Office of Inspector General (OIG) is continuing to deliver supplemental guides geared toward specific subsectors of the healthcare industry....Read More »
CMS recently revised Chapter 4 of the Medicare Claims Processing Manual to provide Method II critical access hospitals (CAH) with updated billing requirements for professional emergency services performed in the...Read More »
Kaiser Permanente has reached a settlement agreement with the United States Department of Justice over documentation practices impacting some Medicare Advantage (MA) risk adjustment payments from 2009‒2018. According to the Office of Inspector General (OIG)...Read More »
