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Healthcare Regulations and Compliance – 2025 Health IT Predictions

Healthcare IT Today

Melissa James, Senior Consultant, Health Language at Wolters Kluwer Health The 2024 OIG reports revealed significant overpayments tied to unsupported diagnosis codes, underscoring the urgent need for MAOs to bolster their compliance efforts. There’s still a need for a compliance framework that is.

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Navigating CMS UPIC Audits: A Guide for Healthcare Organizations

Compliancy Group

Through a combination of data analysis, investigations, medical reviews, and site visits, UPICs scrutinize healthcare providers and suppliers to ensure compliance with billing rules and the provision of medically necessary services. The outcome of these audits can range from repayment of overpayments to criminal prosecution in cases of fraud.

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