The Office of the Inspector General (OIG) has published a resource guide for measuring compliance program effectiveness. During a roundtable meeting in January of this year, OIG compliance professionals and staff discussed all seven elements of a compliance program and suggested ideas about ...

The Merit-based Incentive Payment System (MIPS) is the new payment mechanism in which eligible clinicians earn a performance-based payment adjustment (positive or negative) to their Medicare payments. It is important to note that MIPS adjustments are budget neutral, therefore equal numbers of ...

Through healthcare fraud cases and settlements in 2016, Department of Health and Human Services (HHS) and Department of Justice (DoJ) initiatives returned over $3.3 billion to the federal government and individuals, including $1.7 billion to Medicare Trust Funds, the Office of the Inspector ...

On Friday, October 14th, the Centers for Medicare & Medicaid Services (CMS) released the long awaited Final Rule for the Merit-based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive payment provisions in the Medicare Access and CHIP Reauthorization Act of 2015 ...