Audit activity is expanding in the nursing home sector, with improper payments rising and nursing homes continuing to lead in ...

Nearly 5 percent of eligible hospitals failed their post-payment meaningful use audits, resulting in the those hospitals being required to return their EHR incentive payments, according to data from ...

Indiana's Medicaid office made at least $56 million in "improper" payments for autism therapy services over two years, according to a report released Thursday by the inspector general within the U.S.

Personal care assistants are among those who may stop receiving payments as part of an audit of Medicaid services designed to root out fraud.

Despite revenue growth, healthcare payers have faced increasing margin pressures over the past year as healthcare costs continue to climb. Introducing new efficiencies into key operations such as ...

Unlike traditional post-payment audits that can result in clawbacks, pre-payment audits increase denial risks and cause cash flow issues. Payers also stepped up clinical documentation scrutiny, ...

Last month, CMS announced the implementation of pre-payment audits on providers that participate in Medicare and Medicaid and also participate in electronic health record incentive programs. These pre ...

All U.S. states are currently participating in the Medicaid Audit program and any Medicaid delegated entity can be subject to an audit. This leaves little time for organizations to prepare and few are ...

On September 5, 2025, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) Office of Evaluation and Inspections (OEI) released a Data Snapshot (OEI-BL-24-00420) ...