The Department of Health and Human Services’ Office of Inspector General (“OIG”) will modernize its Compliance Program Guidance (“CPG”) beginning at the end of calendar year 2023. The updates will be posted on the OIG website and the OIG listserv will provide notice of the updates.

OIG expects to start the updates with General Compliance Program Guidance (“GCPG”) that applies to all individuals and entities involved in the healthcare industry. The topics in the GCPG will cover:

  1. Federal fraud and abuse laws;
  2. Compliance program basics,
  3. Operating effective compliance programs, and
  4. OIG’s processes and resources.

OIG expects to issue Industry Specific Compliance Program Guidance (“ICPG”) starting in calendar year 2024. ICPG will address different types of providers, suppliers and other participants in the health care industry subsectors or ancillary industry sectors. OIG reports it will tailor the ICPG updates to address risks of fraud and abuse for each industry subsector and the ICPG will address what steps to take to reduce risks.

OIG reports its first ICPGs will likely cover Medicare Advantage and nursing facilities.

Harris Beach’s New York health care lawyers closely follow Medicaid developments. Should you need anything else on this topic or if you have a matter you wish to pursue with DOH, please reach out to Matthew Babcock at mbabcock@harrisbeach.com to discuss an engagement.

This alert is not a substitute for advice of counsel on specific legal issues.

Harris Beach has offices throughout New York state, including Albany, Buffalo, Ithaca, Long Island, New York City, Rochester, Saratoga Springs, Syracuse and White Plains, as well as Washington D.C., New Haven, Connecticut and Newark, New Jersey.