2025 TPE Audits and the Importance of Internal Auditing in Therapy Practices

The Centers for Medicare & Medicaid Services’ (CMS) 2025 Targeted Probe and Educate (TPE) audits continue to reveal the same issues—missing medical necessity details and incomplete plans of care. These gaps put therapy practices at risk of denials and penalties. Therefore, internal auditing is essential to ensure compliance and audit readiness. As payers and regulators increase scrutiny, documentation and billing are no longer just administrative tasks; they are crucial to reimbursement and long-term sustainability. Internal…

Psychedelic Treatments, Telehealth, and Compliance: What Providers Need to Know

Health providers are facing a period of rapid change. From the rise of psychedelic-assisted therapies to evolving telehealth policies and heightened regulatory scrutiny, organizations must balance innovation with compliance. Proper documentation, coding, and audit preparedness are no longer optional; they are essential for protecting patients, practices, and reimbursement. This article summarizes key takeaways from LW Consulting’s Senior Consultant, Christine Pilarski’s recent workshop on Coding, Billing, Payment, Audit, and Enforcement at the ASKP3 2025 Mastering the…

Why Clinical Laboratories Can’t Afford to Ignore the 2025 OIG iCPG

The Office of Inspector General (OIG) is set to release new General Compliance Program Guidance (iCPG) for clinical laboratories in 2025—and it’s a game changer. For more than 25 years, labs have operated under the same compliance framework. But with the rise of genetic testing, electronic order sets, and complex payer rules, the OIG is updating its expectations. The new iCPG will strengthen oversight, expand data monitoring requirements, and tie laboratory stewardship directly to compliance…