Resources
for You and Your Team
OIG Work Plan Targets Chronic Care Management: What Care Management Companies and Investors Need to Know
The OIG’s 2026 Work Plan includes a major audit of Medicare Chronic Care Management (CCM) services, focusing on eligibility, documentation, and vendor oversight. With rising Part B payments, regulators are targeting compliance risks tied to “multiple chronic conditions” requirements. This article outlines key audit triggers, common red flags, and how care management companies and investors can proactively strengthen compliance ahead of federal scrutiny.
The 2026 MPFS Final Rule: A Pivot Point for Digital Health in RHCs and FQHCs
The CMS CY 2026 MPFS Final Rule ends simplified G-code billing (G0071, G0512) for safety net providers. FQHCs and RHCs must shift to granular CPT/HCPCS coding for virtual check-ins, Chronic Care Management (CCM), and Behavioral Health Integration (BHI). This structural change is a major product roadmap update for digital health vendors serving the rural and community health market. Learn the 4 key billing changes to maintain revenue for your RHC/FQHC partners.