Recent actions by the Centers for Medicare & Medicaid Services (CMS), including targeted spending reviews and the Comprehensive Regulations to Uncover Suspicious Healthcare initiative, known as CRUSH, reflect a measurable shift in federal oversight expectations....
Fraud is evolving faster than traditional controls. Schemes are more coordinated and documentation is more engineered. Billing patterns are designed to survive first-pass reviews. And many organizations are still reacting after payment. If you lead SIU, compliance,...
