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A recent OIG audit found that Medicare improperly paid an estimated $15.2 million for SI joint injections. CJ Wolf examines the coverage, billing, medical necessity, and documentation failures behind the findings and identifies three actions healthcare compliance teams can take to reduce risk.
A compliance control can be documented, automated and still fail to manage risk consistently. An HHS-OIG audit offers a practical example of why healthcare organizations need to look beyond whether controls exist and verify that they actually work.
This thought leadership update explains why it’s more important than ever to communicate in a common language. The piece brings compliance executives up to speed on the role of language and communication in today’s compliance programs. Fresh insights and tips capture the current views of the original author, Jerry Shafran, a compliance industry veteran and seasoned, effective communicator.
AI is moving faster than healthcare policy can keep up. For compliance leaders, the knee-jerk reaction might be avoidance, but blocking AI isn’t an option.
Artificial intelligence is beginning to reshape the compliance landscape, but the field is still in the early stages of adoption. Compared with other business functions, compliance has been slower to embrace AI, especially in healthcare, where concerns about risk, regulation, and potential bleed-over into clinical decision-making have made organizations particularly cautious. Yet the opportunity is substantial, especially when it comes […]