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Payment Integrity Trends 2026: Top 3 Risks & Predictions

Payment Integrity Trends 2026: Top 3 Risks & Predictions

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Analysis‍ of ⁤Source Material

Core Topic: The article discusses upcoming ‌changes in ⁤healthcare regulations for 2026 ⁤and their implications for payers, specifically focusing on payment integrity, fraud, waste, and⁣ abuse (FWA) prevention. It highlights changes in⁤ telehealth, remote patient monitoring (RPM), skin substitutes, and durable ​Medical‌ equipment, Prosthetics, Orthotics, and Supplies (DMEPOS).

Intended Audience: Payers (health insurance companies, Medicare Advantage plans, etc.), payment integrity professionals, compliance‌ officers, and healthcare‍ administrators responsible for managing healthcare costs and preventing fraud.

User Question Answered: The article​ answers the question: “What regulatory changes are coming in 2026 that will impact healthcare payers, ⁢and what steps should⁤ they take to‌ prepare?” It provides a roadmap for proactive planning ⁢and risk mitigation.

Optimal ⁤Keywords

* ⁤ Primary Topic: Healthcare Regulatory Changes & Payment⁤ Integrity
* Primary Keyword: Healthcare regulations 2026
* Secondary Keywords:

⁢ * ‌ ​Telehealth Reimbursement
* Remote Patient Monitoring (RPM)
​‌ * Fraud Waste ​and Abuse‍ (FWA)
* DMEPOS ⁢Accreditation
* Skin Substitute reimbursement
* ‌ Payment Integrity
* CMS Regulations
*‌ Prior ⁣Authorization
* Healthcare‍ Compliance
* ⁣ ⁤Medicare Advantage
​ * Healthcare Reimbursement
* ‌ Risk Mitigation
* Value Based Care
‍ * ⁤ Healthcare Policy
* Cotiviti (as a relevant brand mentioned in the ‍article)

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