Aug 26, 2026 | Forensic AI Alerts
As the market for GLP-1 weight loss medications continues to expand, the introduction of oral formulations has created new opportunities for fraud, waste, and abuse (FWA). While oral GLP-1 therapies may improve patient access and convenience, they also introduce...
Jul 28, 2026 | Forensic AI Alerts
Overview Principal Care Management (PCM) and Chronic Care Management (CCM) are monthly care management services that reimburse providers for coordinating and managing care for patients with qualifying chronic conditions outside of routine office visits. Autism...
Jun 26, 2026 | Forensic AI Alerts
Remote Patient Monitoring (“RPM”) has become one of the most visible examples of technology-enabled care delivery in modern healthcare. What began as a tool to support chronic disease management and extend clinical oversight into the home accelerated rapidly with...
May 28, 2026 | Forensic AI Alerts
Rising Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) expenditures and utilization continue to increase payment integrity risk across healthcare reimbursement. As CMS expands enforcement efforts, including enrollment moratoria for certain...
Apr 30, 2026 | Forensic AI Alerts
What are skin substitutes? A skin substitute is a product that is engineered from human, animal or synthetic materials and is used to treat chronic non-healing wounds such as diabetic ulcers and venous leg ulcers. Skin substitute codes range from Q4100-Q4353 and new...
Feb 27, 2026 | Forensic AI Alerts
Unsupported laboratory services linked to various referral patterns and inappropriate business relationships remain prevalent schemes, with numerous civil and criminal prosecution cases brought by the U.S. Department of Justice. Some referring providers for...
