OIG Issues Updated Compliance Program Guidance
- November 10, 2023
The Department of Health and Human Services Office of Inspector General (OIG) issued November 6 its long-awaited General Compliance Program Guidance (CPG)—a voluntary, nonbinding guidance for stakeholders on health care compliance.
The agency intendes the guidance, part of OIG’s Modernization Initiative, to provide “useful, informative resources to help advance the industry’s voluntary compliance efforts in preventing fraud, waste, and abuse in the health care system.”
OIG said it carefully considered ways to improve and update existing CPGs and to deliver new guidance specific to segments of the health care industry and to entities involved in the health care industry that have emerged in the two decades since the first CPG was issued.
The CPG includes sections on: key federal authorities for entities engaged in health care business; the seven elements of a compliance program; adaptations for small and large entities; other compliance considerations; and OIG processes and resources.
OIG anticipates updating the guidance as changes in compliance practices or legal requirements occur.
Beginning in 2024, the OIG will issue industry segment-specific CPGs (ICPGs) for different types of providers, suppliers, and other participants in health care industry subsectors or ancillary industry sectors.
ICPGs will be tailored to fraud and abuse risk areas for each industry subsector and will address compliance measures that participants can take to reduce risks, OIG said.
The ICPGs will be updated periodically to address newly identified risk areas and compliance measures.