Updates Coming to OIG Compliance Program Guidance

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The Department of Health and Human Services’ Office of Inspector General (“OIG”) will modernize its Compliance Program Guidance (“CPG”) beginning at the end of calendar year 2023. The updates will be posted on the OIG website and the OIG listserv will provide notice of the updates.

OIG expects to start the updates with General Compliance Program Guidance (“GCPG”) that applies to all individuals and entities involved in the healthcare industry. The topics in the GCPG will cover:

  1. Federal fraud and abuse laws;
  2. Compliance program basics,
  3. Operating effective compliance programs, and
  4. OIG’s processes and resources.

OIG expects to issue Industry Specific Compliance Program Guidance (“ICPG”) starting in calendar year 2024. ICPG will address different types of providers, suppliers and other participants in the health care industry subsectors or ancillary industry sectors. OIG reports it will tailor the ICPG updates to address risks of fraud and abuse for each industry subsector and the ICPG will address what steps to take to reduce risks.

OIG reports its first ICPGs will likely cover Medicare Advantage and nursing facilities.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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