IntegrityM Blog

In regulated industries such as healthcare, identifying errors is only part of the equation. The real question is this: what is the total financial impact across the full population? Statistical extrapolation provides that answer. Statistical extrapolation uses results from a proper...

Key Takeaways from NGMA AGT 2026: What Today’s Grants Landscape Means for Federal Agencies and Recipients Kevin Gregory, Project Lead for a federal post-award monitoring contract at IntegrityM and Certified Grants Management Specialist (CGMS), recently attended the National Grants Management ...

Smarter detection starts with letting the data speak for itself.  Unsupervised machine learning is becoming an increasingly valuable tool for detecting anomalies in complex healthcare datasets. As data continues to grow in both volume and complexity, traditional approaches to&n...

AI and machine learning are increasingly central to fraud analytics in complex, highly regulated environments. As adoption accelerates, much of the public conversation focuses on algorithms, new architectures, improved accuracy metrics, and automation at scale. While these advance...

Effective subrecipient monitoring is essential for any pass-through entity that administers federal funds. To “survive” a Single Audit (the comprehensive annual audit for entities expending significant federal funds), organizations must go beyond minimal oversight. They need a structur...

In continuation of our Subrecipient Monitoring series we continue to explore the remaining Pillars. Pillar 2 - Verification: Trust But Verify Subrecipient Compliance Once subawards are made (and risk-tiering is in place), the mantra is “trust but verify.” Verification in subrecipient monit...

In the ongoing effort to protect the Medicare program, deterrence stands out as a powerful and cost-effective strategy. While detection and enforcement remain critical, deterrence shifts the focus from reacting to fraud after it occurs to preventing it before it starts. By increasing the perceiv...

The No Surprises Act, implemented by the Centers for Medicare & Medicaid Services (CMS), marks a major milestone in protecting patients from unexpected medical bills. This landmark legislation, effective January 1, 2022, addresses long-standing issues related to surprise billing and healthca...

The surge in the use of amniotic-derived skin substitutes for chronic wound management, especially among diabetic and elderly patients, has opened the door to significant fraud, waste, and abuse across Medicare, Medicaid, and commercial insurance. With per-unit costs running into thousands of do...

Part 2: Practical Steps to Strengthen Your Compliance Framework What Effective Policies and Procedures Look Like Not all written policies are created equal. To satisfy Uniform Guidance requirements and withstand audits, policies and procedures must be: Comprehensive – Covering all area...