Unified Program Integrity Contractors (UPICs) operate within the universe of Medicare and Medicaid program integrity ...

Jackson Davis HealthCare, a consulting group specializing in RAC audits and appeals, lists three ways RAC audits differ from the traditional Medicare audit process used by Medicare Cost Reports and ...

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced significant changes in its risk adjustment data validation (RADV) audits. The changes focus on speed, the volume of ...

To tighten oversight and minimize overpayments to Medicare Advantage plans, the Centers for Medicare & Medicaid Services (CMS) introduced a new rule in 2023 that revamped the agency’s approach to risk ...

Medicare audits are on the rise in 2026. Florida is one of the states most often targeted. If you run a medical practice and accept Medicare, this affects you directly. Most providers don’t think ...

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In an R.J. Hedges & Associates blog post, Wendy Miller, director of accreditation at Board of Certification/Accreditation, shares tips for facing a Medicare audit. 1 ...

A new federal watchdog audit is ratcheting up pressure on government officials to crack down on billions of dollars in overcharges linked to Medicare Advantage home visits. But so far, the Centers for ...