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🎉 Exciting News for Healthcare Compliance Professionals! 🎉 After years of waiting, the Office of Inspector General (OIG) has finally issued an updated guide on compliance programs. As a long-time user of this guide in both my professional work and teaching, I'm thrilled with this release. It's packed with insights on fraud prevention, federal law compliance, risk assessment, and auditing. Key elements of a compliance program: 1. Compliance Program Infrastructure 2. Effective Lines of Communication with the Compliance Officer and Disclosure Programs 3. Enforcing Standards: Consequences and Incentives 4. Risk Assessment, Auditing, and Monitoring 5. Responding to Detected Offenses and Developing Corrective Action Initiatives 6. Investigations of Violations 7. Reporting to the Government and Implementing Corrective Action Initiatives How about penalties? OIG has the authority to pursue monetary penalties and exclusion through the Civil Monetary Penalties Law (CMPL). Under the CMPL, OIG can pursue assessments in lieu of damages, Civil Monetary Penalties (CMPs), and exclusion from participation in Federal health care programs. The CMPL primarily addresses fraudulent and abusive conduct. Additionally, OIG has additional CMP authorities aimed at specific types of conduct unique to HHS and the Federal health care programs. Feedback OIG does ask for feedback. You can email [email protected]. They are specifically interested in receiving feedback about general compliance considerations and risk areas. Additionally, for questions unrelated to the General Compliance Program Guidance (GCPG) or the Industry Compliance Program Guidance (ICPGs), you can contact OIG through [email protected] for exclusions-related questions, and [email protected] for general inquiries. This updated guide is a game-changer for anyone dedicated to upholding the highest compliance standards in healthcare. #HealthcareCompliance #OIGGuide #ComplianceEducation 🌟

This week, OIG issued modernized General Compliance Program Guidance (GCPG), the first of its anticipated new guidance documents for the health care industry. In addition to reiterating the 7 elements of an effective compliance program, highlights include guidance for right sizing a compliance program to both large and small entities, and a specific call out of #privateequity and other private investment in health care as a potential pain point for compliance. The GCPG does not provide the much-awaited entity- or industry-specific guidance, which will be the subject of forthcoming publications. Read more about the updated GCPG in this article written by my colleagues Nicole Aiken-Shaban, Lesley Reynolds, and Matthew Loughran. #healthcare #compliance

The OIG's recently issued General Compliance Program Guidance covers a broad array of compliance topics in a digestible reference guide that will make life easier for #healthcarecompliance professionals and will be a benefit to all #healthcare industry stakeholders. We explain how this guide may assist a range of organizations. #healthlaw

In late 2023, The Office of Inspector General (OIG) at the Department of Health and Human Services issued its new General Compliance Program Guidance. In this podcast, David Schumacher, Partner and Co-Chair of the Fraud & Abuse Practice at Hooper Lundy & Bookman explains that this document is both evolutionary and revolutionary. For years the OIG’s office had been offering guidance through the Federal Register. To make that information more accessible it moved it online, consolidated the information, added interactive features and created a much richer resource which makes it both easier for compliance teams to understand the OIG’s expectations and more difficult for some to claim that they were unaware of the rules. The changes, though, are more than just the media used to communicate OIG expectations. The document demonstrates both the ongoing expectations by OIG for robust compliance programs and communicates changes in focus. For one, it reveals an enhanced emphasis on quality issues in healthcare and patient safety. It also reflects the OIG’s efforts to ensure effective compliance program in new entrants into healthcare, such as private equity and technology firms. Both may well discover that practices that are permissible elsewhere are not in healthcare. The guidance also encourages incentivizing compliance. Another gem in the guidance is the clear message to carefully scrutinize arrangements with third parties. Due diligence at the outset is important, but it is also necessary on an ongoing basis to determine if the relationship is necessary and the price tag is fair market value. Listen in to learn more, and be sure to check out the General Compliance Program Guidance. https://lnkd.in/gYW8J5gQ

🚦 Navigating the Complex Landscape of Healthcare Compliance 🚦   In the dynamic world of healthcare, staying informed about federal compliance regulations is crucial 🧐. A pivotal piece of this puzzle is the Civil Monetary Penalties Law (42 U.S.C. § 1320a-7a), targeting those who submit false claims. It's vital for healthcare professionals to understand and adhere to these regulations to avoid severe penalties 🚫💲.   The essence of these laws lies in maintaining high ethical standards in healthcare. Non-compliance can lead to financial setbacks and erode trust in healthcare services. Staying ahead in this domain is not just about avoiding penalties; it's about committing to ethical practice 🤝.   EPICompliance simplifies this challenge with comprehensive tools and services. Our offerings, including online courses covering HIPAA, ACA/OIG-Medicare, and OSHA, provide a streamlined approach to compliance 📚🔧. 👉 Click here: https://epicompliance.com/   🔍🏥 How does your practice navigate these complex compliance regulations? Share your strategies and thoughts below 👇. Let's engage in a meaningful discussion!   ❤️ Stay updated. Stay compliant. With EPICompliance.   #HealthcareCompliance #FraudPrevention #HIPAA #EPICompliance    

Compliance Officers: Read the New OIG General Compliance Program Guidance! The OIG's updated General Compliance Program Guidance is a crucial resource for healthcare compliance officers. Our blog post below authored by Kirk Davis and Danielle Gordet, Esq., M.P.H. provides key insights — equipping healthcare stakeholders with the knowledge they need to mitigate risks to their organizations. #HealthCareLaw #OIGGuidance #Compliance https://lnkd.in/gSsTB-F2

What does trust have to do with compliance? In the early days of my career working in healthcare compliance, I struggled with the question of building trust in such a complex landscape. In healthcare, trust isn't just a nice to have. It's an absolute necessity. But how do you get it? As I navigated the world of compliance programs, I discovered the answer lay in the meticulous crafting of policies and procedures, the unwavering commitment to following regulations, and the pursuit of excellence in patient care. With each step, I realized that trust wasn't merely a byproduct of compliance—it was the essence of it. When patients and stakeholders could trust in the integrity of our organization, when they knew that the healthcare organization is not only doing the right thing but looking out for their best interest, that's when real trust grew. So remember, when trust flourishes, patient care improves, organizations thrive, and reputation exceeds the expectation for the industry, especially in healthcare. Is there room for growth within your own company? #Compliance #Trust #HealthcareCompliance

Read our healthcare compliance team's takeaways from the recent OIG General Compliance Program Guidance, led by Greg Demske and Matt Wetzel. https://lnkd.in/eBmzrb62

The Office of Inspector General recently released a new Healthcare Compliance Guidance reference guide useful for understanding healthcare compliance. At its core, it provides a good summary of the laws and regulations central to what we do. However, it doesn’t delve into the nuances that come with experience, so always reach out to you Compliance Professional if you have concerns or questions! https://lnkd.in/ebv3P53D

The regulatory framework for healthcare compliance is becoming increasingly complex. Recent audits and settlements have highlighted significant gaps in compliance, emphasizing the need for robust risk assessment practices. According to Deloitte's 2024 Health Care Industry Outlook, there have been notable impacts on healthcare organizations due to increased regulatory scrutiny. Join us TOMORROW for our next quarterly webcast— #HealthCare #RegulatoryCompliance Hot Topics Roundtable on June 18th at 11am ET. For this quarter, we will cover: • an overview of recent settlements, investigations, and audits that have significantly impacted healthcare organizations. • leading practices and considerations for privacy, helping you navigate complex regulatory requirements with confidence. • critical regulatory developments in 340B, Section 1557, and hospital laboratories essential for maintaining a robust compliance workplan. Register now: https://lnkd.in/eydJzaEZ Don't miss this opportunity to gain insights from industry experts and ensure your organization stays ahead of the curve! Jimmy Firth, Kristi Preuss, Joseph DeSimone, Sarah Stratton, Jenny Penafiel #HealthCare #Compliance #Legal #RevenueCycle #Deloitte #RegulatoryCompliance #Privacy