Compliance
To help health care providers such as hospitals and physicians comply with relevant Federal health care laws and regulations, OIG creates compliance resources, which are often tailored to particular providers.
OIG's compliance documents include special fraud alerts, advisory bulletins, podcasts, videos, brochures, and papers providing guidance on compliance with Federal health care program standards. OIG also issues advisory opinions, which cover the application of the Federal anti-kickback statute and OIG's other fraud and abuse authorities to the requesting party's existing or proposed business arrangement.
Compliance Resources
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The Office of Inspector General (OIG) for the U.S. Department of Health & Human Services has created the educational materials to assist in teaching physicians about the Federal laws designed to protect the Medicare and Medicaid programs and program beneficiaries from fraud, waste, and abuse.
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The Nursing Facility ICPG—together with OIG’s General Compliance Program Guidance (GCPG) that applies to all individuals and entities involved in the health care industry—serves as OIG’s updated and centralized source of voluntary compliance program guidance for nursing facilities. Nursing facilities can use the ICPG to help identify their own risks and implement an effective compliance and quality program to reduce those risks.
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The General Compliance Program Guidance (GCPG) is a reference guide for the health care compliance community and other health care stakeholders. The GCPG provides information about relevant Federal laws, compliance program infrastructure, OIG resources, and other information useful to understanding health care compliance.
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HHS-OIG issues advisory opinions about the application of certain fraud and abuse enforcement authorities to the requesting party’s existing or proposed business arrangements.
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HHS-OIG has several self-disclosure processes that can be used to report potential fraud in HHS programs.
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This online training series includes web-based trainings, job aids, and videos for grantees and health care providers who serve AI/AN communities to learn more about compliance; fraud, waste, and abuse; and health care quality. These trainings are free and provide information and tools that you can apply to help ensure your organization provides quality services to your community and complies with applicable statutes, regulations, and program requirements.
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Single Audits
This section serves as an educational resource for recipients of Federal financial assistance, Federal program officials, and members of the audit community to strengthen their understanding of the scope, and improve the quality, of Single Audits.
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Compliance Toolkits
HHS-OIG has created several toolkits to help providers ensure they are in compliance with health care laws.
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RAT-STATS - Statistical Software
Providers can download this free statistical software package to assist in a claims review.
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Compliance Resources for Health Care Boards
Health Care Boards promote economy, efficiency, and effectiveness. These resources discuss how boards can enhance compliance through involvement in oversight activities as well as by integrating compliance throughout their businesses.
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HEAT Provider Compliance Training
As part of the Health Care Fraud Prevention and Enforcement Action Team (HEAT) Provider Compliance Training, these resources instruct providers what do do when a compliance issue arises.
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Open Letters
The Inspector General occasionally issues letters to health care providers alerting them to OIG policies and processes; inviting them to engage in our anti-fraud initiatives; and updating them on our ongoing projects to fight fraud, waste, and abuse in Federal health programs.
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Compliance Guidance
A series of voluntary compliance program guidance documents directed at various segments of the health care industry
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Safe Harbor Regulations
Rules relating to payment and business practices that do not implicate the federal anti-kickback statute
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Special Fraud Alerts, Bulletins, and Other Guidance
Alerts, bulletins, and guidance published by HHS-OIG
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Request for Information: Modernization Initiative To Improve HHS-OIG Public Resources
A request for information seeking input on how HHS-OIG could improve their public resources.
Disclaimer
These educational materials were current at the time they were published and posted to OIG's Web site. They were prepared as educational resources; they are not intended to create any rights, privileges, or benefits. Although every reasonable effort has been made to ensure the accuracy of the information within these materials, the ultimate responsibility for complying with the Federal fraud and abuse laws lies with the provider of services. OIG employees, agents, and staff make no representation, warranty, or guarantee that these compilations of information are error free and will bear no responsibility or liability for the results or consequences of their use. These materials are summaries that explain certain aspects of the Federal fraud and abuse laws, but are not legal documents. The official information is contained in the relevant laws and regulations.