Healthcare is a multi-trillion-dollar industry that remains highly regulated.  When organizations bill for services, they are reimbursed on a good-faith basis with the expectation that clinical documentation supports the services reported and regulatory compliance has been met.  Every year the OIG releases their respective work plan which highlights areas and services that represent high priority audit targets during the upcoming year.   Each year the OIG releases their respective work plan which highlights areas and services that represent high priority audit targets during the upcoming fiscal year and release monthly updates to the work plan.   It is imperative for organizations to stay diligent and apprised of these compliance initiatives and be especially proactive in their compliance efforts, conduct regular audits of processes and clinical documentation, and comply with the mandatory self-reporting requirements set forth by the Affordable Care Act. 

In this webinar our expert speaker will  discuss the key governing authorities involved in healthcare compliance in 2025, pathways involved in audits and investigations, review the OIG work plan with most recent updates, spotlight current audit trends and audit targets in 2025, identify relevant action protocols, discuss examples of the latest OIG advisory opinions, identify elements of an effective compliance plan based on recent updates, and discuss actionable best practice tips to set you up for success in 2025 and beyond.

Webinar Objectives

This session will cover the key governing authorities involved in healthcare compliance, dissect various pathways involved in audits and investigations, review the OIG 2025 work plan, spotlight 2025 audit trends and audit targets, identify relevant action protocols, discuss recent OIG advisory opinions, identify elements of an effective compliance plan, and discuss actionable best practice tips for success in 2025.

Webinar Agenda

• Understand the governing authorities involved in overseeing and enforcing healthcare compliance in 2025
• Recall the role of the OIG Work Plan
• Recognize 2025 trends and OIG audit targets in healthcare compliance
• Recall overpayment and voluntary refund protocols in 2025
• Recognize when the OIG self-disclosure protocol may be appropriate
• Understand recent OIG Advisory Opinions

Webinar Highlights

• Outline the governing authorities involved in overseeing and enforcing healthcare compliance in 2025
• Review the various pathways involved in healthcare compliance audit and investigations in 2025
• Discuss the role of the OIG Work Plan in 2025
• Deconstruct 2025 trends and OIG audit targets in healthcare compliance
• Discuss fee-for-service audit targets in 2025
• Review risk-adjustment audit targets in 2025
• Define the process of audit error rate extrapolation in 2025
• Identify key elements of an effective compliance plan based on the OIG framework in 2025
• Review the overpayment and voluntary refund protocols for 2025
• Discuss when the OIG self-disclosure protocol may be appropriate
• Review relevant and recent OIG Advisory Opinions
• Discuss proactive compliance best practice tips for 2025

Who Should Attend?

• Medical Coding Specialists
• Medical Billing Specialists
• Medical Auditing Specialists
• Private Practice Physicians
• Managed Care Professionals
• Operations Leadership
• Practice Administrators
• Office Managers
• Compliance Officers/Committees  
• Chief Medical Officer