Delivering audit results to healthcare providers is rarely a straightforward task.

As we step into 2025, Medicare has introduced updates that bring more flexibility and reduced administrative burdens for physical therapists (PTs), occupational therapists (OTs), and their assistants. These changes aim to improve patient access to therapy services while addressing long-standing concerns in rural and underserved areas. Here's a breakdown of the key updates and what they mean for your practice.

This article emphasizes the need for healthcare institutions to focus on building a culture of safety through Root Cause Analysis (RCA) to manage clinical risk.

A California man pleaded guilty to health care fraud, aggravated identity theft, and money laundering in connection with a years-long scheme to defraud Medicare of more than $17 million through sham hospice companies and his home health care company.

LabCorp and University Health System Agree To Pay $388,667 To Resolve Alleged False Claims Act Violations

When it comes to human resources in healthcare, it's important for medical practices to follow laws related to employees and patient care. HR ensures that employees are treated fairly, follows safety guidelines, and respects patient rights. Noncompliance can lead to legal penalties, compromise patient care, and harm your practice's reputation.

'Twas the night before auditing, and all through the floor, The auditors prepped, ready to explore. The charts were all stacked, each file in its place, While audit reports awaited their grace.

Patient Harm: Nearly one in four physicians (24%) reported that prior authorization has led to serious adverse events, including hospitalization, permanent impairment, or death. Furthermore, 93% of physicians observed a negative impact on clinical outcomes, and 94% noted delays in accessing necessary care, often causing patients to abandon their treatment due to struggles with health insurers.

Healthcare audits are essential for analyzing operational compliance and adherence to quality standards. Also called clinical or medical audits, these processes generally assess where providers and staff are doing well and where they can improve. Audits in healthcare can support an improved patient experience, staff accountability, and healthier revenue cycle management (RCM).

This week, the Centers for Medicare and Medicaid Services (CMS) released a report detailing complaints and enforcement actions related to the Public Health Service Act, which encompasses the No Surprises Act.