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How the OIG’s New General Compliance Program Guidance (GCPG) Addresses the Seven Elements  

OIG's GCPG Denise atwood

“Compliance officers can make the most of the new GCPG to meet the requirements of the OIG’s seven elements in a relevant and meaningful way.”

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board of directors HIPAA OIG regulatory change management risk management Tips

Key Takeaways from OIG’s New General Compliance Program Guidance (GCPG) 

Degroot OIG GCPG

“Throughout the GCPG, helpful revisions and clarity are provided to a few areas that have proven problematic over the years.”

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HIPAA How to OIG regulatory change management

Key Takeaways from OIG’s Newly Released General Compliance Program Guidance 

Key Takeaways from OIG’s General Compliance Program Guidance - cj wolf

“Successful compliance programs are adapted to fit the organization and maximize compliance for individual organizations with unique risk profiles.”

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Compliance Culture HIPAA OIG regulatory change management revenue cycle

Key Takeaways from OIG’s New General Compliance Program Guidance (GCPG) 

Key Takeaways from OIG’s New General Compliance Program Guidance (GCPG) - Shawn DeGroot

“Throughout the GCPG, helpful revisions and clarity are provided to a few areas that have proven problematic over the years.”

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HIPAA How to OIG regulatory change management

New, Stronger Evaluation and Management Upcoding Enforcement 

upcoding enforcement evaluation and management CJ Wolf

“Earlier this year, regulators made the most significant changes to E&M documentation and coding guidelines in over two decades. They’re more complex than ever before, and enforcement actions are increasing.”

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regulatory change management revenue cycle

Increasing Enforcement of Modifier Codes 

enforcement of modifier codes cj wolf

“Enforcement agencies like to “follow the money,” so to speak, and they often find it in medical claims submitted to government payors such as Medicare and Medicaid. This is why selecting appropriate modifier codes is essential for operating and being reimbursed compliantly.”

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regulatory change management revenue cycle

Recent Telehealth Enforcement and How to Prepare   

telehealth enforcement cj wolf healthcare compliance

“As healthcare fraud, waste, and abuse continues to emerge, and poses more of a risk to organizational compliance, professionals should become familiar with some of the potential areas of noncompliance associated with telehealth.”

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How to OIG regulatory change management revenue cycle

Significant Upcoding Risks Emerge with Medicare Advantage

significant upcoding risks emerge with medicare advantage

Christi Grimm, the Inspector General of HHS, gave a recent keynote address to compliance professionals. In it, she said, “Simply put, the financial incentives created by risk adjustment may be driving upcoding in the severity of diagnoses to garner additional payments.”

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OIG regulatory change management revenue cycle

Telehealth Enforcement Actions

telehealth enforcement cj wolf

“It behooves all healthcare compliance professionals to be aware of the fraud, waste and abuse risks associated with telehealth services. This mode of delivery holds great promise. For it to fulfill that promise, non-compliance needs to be rooted out and corrected.”

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OIG regulatory change management revenue cycle
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