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As Biden admin. takes shape, expect closer scrutiny on compliance, HIPAA, billing

The advent of a new presidential administration is expected to bring changes in health care compliance enforcement: You should watch for the new wave of HHS, CMS and Department of Justice (DOJ) agencies to go after big health care-related crimes. They’re also likely to scrutinize HIPAA and the big payments made to help providers over the COVID-19 hump.

In the days since his Jan. 20 inauguration, President Joe Biden has issued several executive orders pertaining to health care, including a COVID-19 vaccination program, and has publicized plans for health care reform, such as increased subsidies for the Affordable Care Act.

Concrete progress on those fronts will largely depend on Congress and the actions of Biden’s as-yet-unappointed department heads, including HHS Secretary nominee Xavier Becerra and Attorney General nominee Merrick Garland. Once the team is in place, however, you can expect policy adjustments that will lead federal auditors, investigators and prosecutors to pay closer attention to certain health care compliance areas than the previous administration did.

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