AI Alert June 2025

AI Alert June 2025

Navigating Medication Therapy Management: Policies, Practices, and Identifying Potential Fraud, Waste, and Abuse  Medication Therapy Management (“MTM”) has been shown to improve overall health and well being. MTM programs typically involve comprehensive medication...
AI Alert May 2025

AI Alert May 2025

Fighting Bad Behavior: Addressing Fraud, Waste, and Abuse in Applied Behavior Analysis As Applied Behavior Analysis (ABA) services for autism spectrum disorder continue to grow, so does the risk of fraud, waste, and abuse (FWA). With the implementation of the Mental...
AI Alert April 2025

AI Alert April 2025

Peeling Back the Layer of Skin Substitutes Background  A skin substitute is a material used to replace or support damaged skin tissue. Skin substitutes may be allogeneic, xenogeneic, synthetic or a combination of these types of materials. When used appropriately,...
AI Alert March 2025

AI Alert March 2025

Bridging the data gap between medical and dental claims  What fraud, waste, and abuse concerns are common to dental claims?  The increased coverage and spend for dental services by health plans and health agencies will expand the opportunity for fraud, waste, and...
AI Alert February 2025

AI Alert February 2025

Understanding the Impact of Coding Changes on Psychological and Neurological Testing  New codes for psychological and neurological testing services since 2019 provide clarification of non-face-to-face work by professionals. The codes have been enhanced with...