By Adam Turteltaub

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.