For hospitals, physicians, and Advanced Practice Providers, 2026-2027 brings an unprecedented level of scrutiny from federal auditors. Office visits, split/shared services, critical care billing, and hospital admissions are all under the microscope of the OIG, RACs, UPICs, ZPICs, CERTs, and your own MACs. Even one misreported claim can spark a costly investigation or repayment demand. From small clinics to hospital-employed practices, no one is immune as the alphabet soup of federal and Medicare Advantage auditors zeroes in on documentation, coding accuracy, and compliance integrity across common services.

Hospitals, outpatient clinics, ASCs, and health networks are also shouldering extraordinary compliance pressure as the government intensifies its recovery and enforcement pursuits. In 2025, HHS reported $16.61 billion in recoupments and $50 billion in projected savings from provider enforcement actions, numbers that underscore what’s at stake when compliance slips. Federal auditors are targeting a wide range of services in 2026-2027, including implantable device credits, the Two-Midnight Rule, inpatient-only list deletions, outpatient wound care reporting, observation services, and split/shared E/M billing. Every hospital type and specialty setting is in the line of sight.

This webcast, led by Michael Calahan, PA, MBA, helps attendees clearly identify the “Top 10” audit and compliance target areas and prepare their organizations accordingly. Drawing from current federal audit findings, CMS policy updates, and enforcement patterns, Michael distills complex requirements into practical strategies your teams can use immediately. Participants will learn how to apply compliant documentation, interpret regulatory shifts, and strengthen internal review processes to mitigate risk before external auditors identify costly vulnerabilities.

Michael will also discuss the “topic of the day” — Artificial Intelligence (AI) and how the OIG is leveraging AI modalities and techniques to detect patterns, identify providers, and hone in on services prone to fraud, waste, and abuse. A short introductory segment will lead off the Top-10 presentation, including how AI is being applied at the provider level (hospitals and individual providers) and why OIG and other federal auditing entities are raising red flags about AI’s integration into healthcare. This context gives your team a clearer view of how they may be evaluated, by both humans and algorithms.

Why This is Relevant:

Now is the time to act. Federal and state auditors are ramping up parallel reviews, expanding their use of AI and data analytics to flag outliers faster and more frequently. Waiting to respond until auditors arrive could mean millions in exposure for your facility, or even legal jeopardy for providers. Equip your teams now with the insights, strategies, and corrective guidance needed to thrive under the coming wave of scrutiny. This webcast provides the edge you need for audit readiness and peace of mind.

Learning Objectives:

• Identify the “Top 10” compliance target areas for 2026-2027 across hospitals and physician practices.
• Drill down into each audit focus area to understand risk pain points and mitigation strategies.
• Review updated CMS coverage and compliance guidelines specific to Medicare, Medicaid, and Medicare Advantage.
• Analyze lessons learned from recent federal audit and enforcement activity.
• Apply practical best practices to minimize audit exposure and respond effectively to compliance reviews.

Who Should Attend:

• C-Suite Executives Responsible for Physician Services – Hospital-Based Exec’s
• Hospital Staff supporting/interfacing w/ Physician Services – Various Titles
• Other Hospital Staff including Physician Network “bridge” Exec’s, Directors & Managers
• Physician Liaison Staff
• Providers: MDs, DOs, Podiatrists (DPMs)
• Hospital Clinic Providers: MDs, Dos, Podiatrists (DPMs)
• NonPhysician Providers – “Advanced Practice Providers”: PAs, NPs, CNSs, CNMs
• Physician Practice Administrators
• Physician Office Managers
• Physician Services Auditing Teams
• Physician Auditing Specialists
• Physician Coders
• Physician Billers
• “Corporate Responsibility Officers” (compliance staff working w/ Physicians)
• Hospital HIM Department (V.P., Director, Manager, Assistant Director, Assistant Manager) overseeing Physician Coding
• Hospital Revenue Cycle Staff overseeing Physician Billing
• Clinical Documentation Improvement (CDI) Specialists
• Medicare Advantage - Physician Practice Liaisons