Compliance

What You Need to Know About Medicare Advantage Oversight

Medicare Advantage (MA) enrollment has grown rapidly and now covers more than half of all Medicare beneficiaries — 32.8 million people in 2024. With this growth comes increased oversight from regulators, especially the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). In February 2026, the OIG released new Medicare Advantage […]

Published Date: April 1, 2026

What the CMS QAPI Changes Mean for Your Medical Practice

Healthcare regulations continue to evolve, and one of the most important upcoming shifts involves the Centers for Medicare & Medicaid Services (CMS) Quality Assurance and Performance Improvement (QAPI) expectations. These requirements are designed to push healthcare organizations toward continuous quality improvement, stronger patient safety practices, and data-driven decision making. For your medical practice, QAPI isn’t […]

Published Date: March 19, 2026

Why Your Medical Practice Must Designate a HIPAA Compliance Officer (And How to Do It Right)

If you manage a medical practice, protecting patient health information isn’t optional — it’s a federal legal requirement. Under HIPAA, your practice must designate a HIPAA Compliance Officer responsible for privacy, security, and regulatory oversight. According to the U.S. Department of Health & Human Services (HHS) HIPAA Privacy Rule, covered entities must assign a privacy […]

Published Date: March 10, 2026

Federal Training Requirements: How Your Team Stays Compliant and Avoids Costly Mistakes

Healthcare compliance isn’t optional — federal regulations continue tightening around privacy, billing accuracy, workplace safety, and documentation requirements. If your staff isn’t properly trained, your practice risks audits, claim denials, penalties, and patient safety issues. Structured annual training protects your revenue, your patients, and your reputation. As emphasized in your original compliance guide, ongoing education […]

Published Date: March 5, 2026

3 Balance Billing Best Practices Every Practice Must Know

The balance billing rules that went into effect in 2022 under the No Surprises Act continue to cause confusion for medical practices and hospitals across the country. And confusion can lead to violations that can land your practice in serious legal trouble. Check out three balance billing best practices that can help you stay compliant […]

Published Date: January 5, 2026

3 Provider Training Tips to Deploy After Your Internal Audit

Completing an internal audit is a major accomplishment, and it’s only the beginning. The real value comes from what happens next: using those findings to strengthen your team’s documentation, coding accuracy, and overall compliance. That process starts with identifying problem areas and turning them into clear, actionable training opportunities for physicians, billers, and other staff. […]

Published Date: November 24, 2025

How to Respond if Your Payer Says You’re an ‘Outlier’

Has your practice ever gotten notified that you’re an outlier? If so, you may realize the fear this can create, and the possibility that you may end up getting audited or seeing your claims downcoded. Not every outlier letter means you’ll face lost revenue, but it can still be upsetting. Check out a few steps […]

Published Date: November 5, 2025

5 Keys to Internal Audit Success at Your Medical Practice

An internal audit can help your practice identify any errors in your billing, coding or medical records, and can help you discover whether you’re violating any regulatory requirements. These audits can be prospective (where you review claims prior to submitting them) or retrospective (when you review claims that were paid). Whichever you choose, remember that […]

Published Date: October 28, 2025

5 Medical Recordkeeping Do’s and 5 Don’ts to Stay Compliant

Experts believe that eight in every 10 medical bills contain errors, which means the majority of medical practices are setting themselves up for denials, as well as accusations of fraud, waste and abuse. The best way to avoid issues is to maintain accuracy in your coding, billing and medical recordkeeping practices. To stay on the […]

Published Date: October 15, 2025

Key Takeaways From 3 Recent Physician Fraud Cases

Sometimes things can get so busy at your medical practice that you may accidentally let compliance fall through the cracks. One way to remind yourself how important Medicare compliance is to review recent cases of physician fraud. These may show you the many ways that other practices are falling short and putting themselves at risk […]

Published Date: September 17, 2025

Compliance

Compliance

What You Need to Know About Medicare Advantage Oversight

What the CMS QAPI Changes Mean for Your Medical Practice

Why Your Medical Practice Must Designate a HIPAA Compliance Officer (And How to Do It Right)

Federal Training Requirements: How Your Team Stays Compliant and Avoids Costly Mistakes

3 Balance Billing Best Practices Every Practice Must Know

3 Provider Training Tips to Deploy After Your Internal Audit

How to Respond if Your Payer Says You’re an ‘Outlier’

5 Keys to Internal Audit Success at Your Medical Practice

5 Medical Recordkeeping Do’s and 5 Don’ts to Stay Compliant

Key Takeaways From 3 Recent Physician Fraud Cases

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