The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) is the largest inspector general’s office in the federal government and is tasked with providing oversight to more than 100 federal...more
3/2/2026
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance Monitoring ,
Corporate Integrity Agreement ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Electronic Medical Records ,
EMTALA ,
False Claims Act (FCA) ,
Government Agencies ,
Guidance Documents ,
Guidance Update ,
Health Care Providers ,
Healthcare ,
New Guidance ,
OIG ,
Regulatory Oversight
Bass, Berry & Sims is pleased to bring you our 14th annual Healthcare Fraud & Abuse Review in which we cover significant civil and criminal enforcement issues for healthcare providers....more
2/17/2026
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Controlled Substances Act ,
Criminal Prosecution ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
EHR ,
Enforcement Actions ,
False Claims Act (FCA) ,
Government Investigations ,
Health Care Providers ,
Healthcare Fraud ,
Medicaid ,
Medicare ,
OIG ,
Qui Tam ,
Whistleblowers
On February 3, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued new Medicare Advantage Industry Segment-Specific Compliance Program Guidance (MA ICPG) for the MA industry and...more
2/9/2026
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance Management Systems ,
Compliance Monitoring ,
Department of Health and Human Services (HHS) ,
Health Insurance ,
Healthcare Fraud ,
Marketing ,
Medicare Advantage ,
Medicare Advantage Organizations (MAOs) ,
New Guidance ,
OIG ,
Quality of Care Standards ,
Regulatory Oversight ,
Risk Management ,
Third-Party Service Provider
On January 16, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published Advisory Opinion 26-01, approving a proposal by the manufacturer of a clinical laboratory test used to screen for...more
1/30/2026
/ Advisory Opinions ,
Anti-Kickback Statute ,
Civil Monetary Penalty ,
Clinical Laboratory Testing ,
Co-payments ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Eliminating Kickbacks in Recovery Act of 2018 (EKRA) ,
FDA Approval ,
Food and Drug Administration (FDA) ,
Health Insurance ,
Medicaid ,
Medicare ,
OIG ,
Preventive Health Care ,
Regulatory Oversight
On December 18, 2025, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published favorable Advisory Opinion 25-11, approving various discount structures, including bundled discounts and...more
1/12/2026
/ Advisory Opinions ,
Anti-Kickback Statute ,
Compliance Monitoring ,
Department of Health and Human Services (HHS) ,
Discounts ,
Healthcare Fraud ,
Medicaid ,
Medicare ,
Medicare Part B ,
Medicare Part D ,
OIG ,
Pharmaceutical Industry ,
Rebates ,
Regulatory Oversight ,
Reimbursements ,
Reporting Requirements ,
Safe Harbors ,
Statutory Interpretation
On June 20, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published Advisory Opinion 25-04, in which it declined to approve a proposal by a medical device company (Requestor) to pay the...more
On June 11, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published Advisory Opinion 25-03, approving a proposal by a management services organization (MSO) and its friendly PC...more
6/25/2025
/ Advisory Opinions ,
Anti-Kickback Statute ,
Contract Terms ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Insurance ,
Healthcare Fraud ,
Medicaid ,
Medicare Advantage ,
OIG ,
Patient Access ,
Proposed Rules ,
Safe Harbors ,
Telehealth
In 2024, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) provided useful insights to the healthcare industry regarding how it approaches various fraud and abuse issues in an...more
2/7/2025
/ Anti-Kickback Statute ,
Billing ,
Compliance ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Healthcare ,
Healthcare Fraud ,
Medicare ,
Medicare Advantage ,
OIG ,
Risk Management ,
Settlement ,
Stark Law ,
Telehealth
As some packed the skis and headed to their favorite slopes this winter season, it is hard not to see the analogies to the healthcare private equity (PE) transaction market as we ring in the New Year. Much like the Northern...more
On December 11, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a Special Fraud Alert (SFA) on what it refers to as “suspect” marketing schemes involving “questionable payments and...more
On September 13, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published Advisory Opinion 24-08, in which it declined to approve a proposal by a Medicare Advantage organization (MAO)...more
9/19/2024
/ Advisory Opinions ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Employer Group Health Plans ,
Health Insurance ,
Healthcare ,
Medicare ,
Medicare Advantage Organizations (MAOs) ,
OIG ,
Shared Savings Program
On June 17, the U.S. Department of Health and Human Services Office of Inspector General (OIG) posted Advisory Opinion 24-03, approving an arrangement under which a pharmaceutical manufacturer provides travel, lodging, and...more
6/28/2024
/ Advisory Opinions ,
Anti-Kickback Statute ,
Fraud and Abuse ,
Health Insurance ,
Healthcare ,
Life Sciences ,
Medicaid ,
Medicare ,
OIG ,
Pharmaceutical Industry ,
Prescription Drugs
The recent Request for Information by the Federal Trade Commission (FTC), Department of Justice (DOJ) and Department of Health and Human Services (HHS) seeking input on the effects of private equity (PE) investment in the...more
We are pleased to bring you our 12th annual Healthcare Fraud & Abuse Review. Our Review provides comprehensive coverage of the most significant civil and criminal enforcement issues facing healthcare providers. Each year, we...more
2/27/2024
/ Anti-Kickback Statute ,
CARES Act ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare ,
Healthcare Fraud ,
Kickbacks ,
Medical Devices ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Qui Tam ,
Settlement ,
Stark Law ,
Telemedicine
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) is tasked with providing objective oversight to protect the integrity and promote the efficiency of Medicare, Medicaid, and more than...more
2/1/2024
/ Advisory Opinions ,
Anti-Kickback Statute ,
Civil Monetary Penalty ,
Department of Health and Human Services (HHS) ,
Enforcement Actions ,
Health Information Technologies ,
Healthcare ,
Healthcare Fraud ,
Healthcare Reform ,
Information Blocking Rules ,
Litigation Strategies ,
New Guidance ,
OIG ,
Regulatory Agenda ,
Telehealth
On January 11, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) published a Final Rule that seeks to provide clarity regarding OCR’s enforcement authority and processes relating to federal...more
On January 3, the U.S. Department of Health and Human Services Office of Inspector General (OIG) posted Advisory Opinion 23-15, approving a physician practice consultant’s proposal to offer gift cards to its customers when...more
On October 13, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued Advisory Opinion 23-07, approving a physician practice’s proposal to pay its physician-employees a portion of the...more
10/19/2023
/ Advisory Opinions ,
Ambulatory Surgery Centers ,
Department of Health and Human Services (HHS) ,
Employer Liability Issues ,
Healthcare ,
Healthcare Reform ,
OIG ,
Physicians ,
Profits ,
Proposed Regulation ,
Safe Harbors
On September 25, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued Advisory Opinion 23-06, in which it declined to approve an anatomic pathology laboratory’s proposal to purchase...more
The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) continues to offer valuable insights to the healthcare industry as to how best to approach increasingly complex healthcare fraud...more
4/11/2023
/ Advisory Opinions ,
Consolidated Appropriations Act (CAA) ,
Department of Health and Human Services (HHS) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare ,
Healthcare Reform ,
OIG ,
Physicians ,
Request For Information ,
Self-Disclosure Requirements ,
Telemedicine ,
Wellness Programs
The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently issued Advisory Opinion 23-03, approving a proposal by the manufacturer of a colorectal cancer screening test and its wholly owned...more
On March 23, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) announced a new, expanded frequently asked questions (FAQs) process. Although OIG has long maintained FAQs on...more
On February 23, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services issued Advisory Opinion 23-02, approving a pharmaceutical company’s program to provide a free 14-day supply of an...more
The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services recently posted Advisory Opinion 22-20, approving an acute care hospital’s arrangement under which its employed nurse practitioners...more
1/6/2023
/ Acute Facilities ,
Advisory Opinions ,
Anti-Kickback Statute ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Hospitals ,
Nurse Practitioners ,
OIG ,
Physicians ,
Remuneration ,
Stark Law
On October 5, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services published Advisory Opinion No. 22-19, finding that a proposal by an entity funded entirely by manufacturers of oncology...more
10/12/2022
/ Advisory Opinions ,
Anti-Kickback Statute ,
Appeals ,
C-Corporation ,
Cost-Sharing ,
Federal Poverty Line ,
Fraud and Abuse ,
Generic Drugs ,
Inflation Reduction Act (IRA) ,
Medicare Part D ,
OIG ,
Patient Assistance Programs