Navigating OIG Regulations with Confidence

Stay ahead of OIG regulations with Compliatric’s robust compliance management features. From monitoring exclusion lists to ensuring transparency in financial relationships, we’ve got you covered.

Proactive OIG Risk Assessments

Compliatric identifies potential vulnerabilities, ensuring preemptive action to safeguard your organization against compliance risks.

Automated Exclusions Monitoring

Ensure compliance by automatically checking against OIG’s List of Excluded Individuals and Entities (LEIE), SAM, and other federal and state lists. Our platform keeps a real-time record of all employees, contractors, and vendors, running checks as required.

Manage potential OIG violations with Compliatric’s incident response tools. Our platform facilitates prompt identification, investigation, and reporting of any incidents involving compliance breaches, ensuring timely remediation.

Conduct thorough risk assessments to identify vulnerabilities in your compliance with OIG regulations. Our platform offers guided evaluations, helping you systematically analyze and mitigate risks, whether they’re associated with equipment or outside vendors.

Enhance organizational compliance with OIG guidelines by enforcing robust data security measures. Compliatric ensures that sensitive healthcare data is protected against unauthorized access and breaches.

OIG Compliance Monitoring and Reporting

Ensure your organization adheres to the highest standards of compliance with our robust monitoring and reporting tools.

Financial Transparency & Reporting

Facilitate the creation, management, and electronic signing of Business Associate Agreements (BAAs) crucial for compliance with OIG regulations. Our platform ensures secure and efficient handling of vendor relationships.

Manage the complete policy lifecycle with our policy management software. From creation to tracking employee attestations and review dates, our platform ensures compliance with OIG regulations.

Empower your staff with knowledge on OIG regulations through Compliatric’s learning management system (LMS). Deliver targeted training modules on regulations and best practices for compliance with OIG mandates.

Utilize Compliatric’s customizable framework aligned with OIG’s extensive regulatory requirements. Assess your current compliance status, identify gaps, and implement necessary controls to safeguard your organization effectively.

HIPAA Glossary

Key HIPAA terms and abbreviations to help on your compliance journey

OIG
(Office of Inspector General)

The agency within the U.S. Department of Health and Human Services that protects the integrity of departmental programs as well as the health and welfare of program beneficiaries.

False Claims Act (FCA)

A law that allows the government to recover losses caused by fraudulent claims made to federal programs, including healthcare programs.

Anti-Kickback Statute (AKS)

Federal law that prohibits exchanging anything of value to induce or reward referrals of federal healthcare program business.

Stark Law
(Physician Self-Referral Law)

Legislation that forbids a physician from referring patients to receive designated health services payable by Medicare or Medicaid to an entity with which the physician (or an immediate family member) has a financial relationship, unless exceptions apply.

Civil Monetary Penalties Law (CMPL)

Authorizes the imposition of penalties against entities that submit false claims or otherwise violate health care laws and regulations.

Exclusion Authority

The OIG’s power to prohibit individuals and entities from participating in federal health care programs due to convictions for program-related fraud and patient abuse, among other reasons.

Corporate Integrity Agreements (CIA)

Agreements between the OIG and healthcare providers that resolve investigation issues but allow providers to remain active in federal healthcare programs under specific oversight to prevent future misconduct.

Compliance Program Guidance

Documents published by the OIG to promote voluntary compliance with the statutes, regulations, and guidelines relevant to federal health care programs.

Qui Tam Provision

A provision in the False Claims Act that allows private individuals to file lawsuits on behalf of the government, alleging that fraud has been committed against federal programs.

Health Care Fraud

Deliberate deception or misrepresentation that results in unauthorized benefits to the individual or some other party.

Advisory Opinions

Formal documents issued by the OIG giving guidance on specific anti-kickback or other health care-related issues, clarifying whether certain behaviors could potentially result in enforcement action.

Sanctions

Penalties that the OIG may impose on individuals and entities that commit fraud or other offenses against HHS programs.

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Frequently Asked Questions

What is the Office of Inspector General (OIG)?

The OIG is a federal oversight body responsible for ensuring the integrity of programs within the Department of Health and Human Services, including Medicare and Medicaid.

The OIG enforces several key healthcare regulations, including the Anti-Kickback Statute, the Stark Law, and the False Claims Act, among others.

Compliatric provides tools for automated exclusion checking, policy management, and risk assessments to ensure that organizations meet or exceed OIG compliance standards.

An exclusion check involves verifying that no current or potential employee or vendor is barred from participating in federal healthcare programs. It’s crucial for avoiding penalties and maintaining program integrity.

Yes, Compliatric helps organizations develop and implement the compliance activities required under Corporate Integrity Agreements, including effective training programs and internal controls.

A Qui Tam lawsuit is a whistleblower lawsuit where an individual can sue on behalf of the government to report fraud in federal healthcare programs. Such lawsuits can lead to significant financial penalties and reputational damage.