Claims Processing Quality Assurance Programs
Key Points: Enforcement actions related to healthcare claims, especially those involving hospitals, are not only common but on the rise.…
Small Entity Compliance Programs
Most enforcement efforts involve small entities that lack compliance programs Both the Office of Inspector General (OIG) and the Department…
Corporate Compliance Root Cause Analysis
Guidance on conducting Root Cause Analysis The Department of Justice (DOJ), in its “Evaluation of Corporate Compliance Program Effectiveness”, emphasizes…
Increasing Compliance Officer Retirements Creating Recruitment Problems
Key Points: Increasing retirement and an already limited pool of trained healthcare compliance professionals has caused a noticeable shortage of…
Risk Assessment for Skilled Nursing Facilities: Understanding Compliance RequirementsÂ
Nursing facilities are the backbone of American healthcare, with 15,000 facilities caring for 1.2 million residents. 1But from ongoing staffing…
AI in Healthcare Compliance: Everything Leaders Should KnowÂ
Healthcare leaders face a dilemma: while a growing body of research demonstrates how artificial intelligence (AI) can improve diagnostics, reduce…
Enterprise Risk Management: How Leading Healthcare Organizations Reduce Compliance RiskÂ
Healthcare organizations can no longer afford to take a reactive approach to risk management – and enterprise risk management (ERM)…
Independent Compliance Program Assessments
Results from the 2025 Compliance Benchmark Survey The 2025 Compliance Benchmark Survey, conducted by SAI360 and Strategic  Management Services, LLC,…
We’re Attending the 29th Annual HCCA Compliance Institute – Let’s Connect
We are excited to be attending the 29th Annual HCCA Compliance Institute in Las Vegas from April 28 to May…
What Is Healthcare Compliance?
Healthcare compliance is the ongoing process of aligning an organization’s operations, billing practices, and workforce conduct with the legal, ethical,…
Increased Enforcement Actions in 2025
Key Points: A new DHHS Inspector General, Thomas March Bell, has been nominated as of March 25th, and the Department…
Compliance Policy Management
Both the Department of Health and Human Services Office of Inspector General and the U.S. Sentencing Commission call for developing,…