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Audits Enforcement Actions Office of the Inspector General

King & Spalding

OIG Audit of Provider Relief Fund Payments to Hospitals Finds Substantial Noncompliance with Federal Requirements

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On June 13, 2025, OIG announced the results of an audit it conducted of 30 hospitals that received provider relief fund (PRF) payments during COVID-19 (the Audit). OIG found that 11 of the 30 audited hospitals failed to...more

Epstein Becker & Green

CMS Doubles Down on Medicare Advantage Recoupment: Announces Aggressive RADV Strategy to Reclaim Billions

Epstein Becker & Green on

On May 21, 2025, the Centers for Medicare & Medicaid Services (CMS) announced an aggressive plan (Plan) to expand its efforts to address fraud, waste, and abuse in Medicare Advantage (MA)....more

Gardner Law

Why Compliance Audits Are Non-Negotiable

Gardner Law on

In today’s heightened enforcement environment, compliance auditing isn’t just a best practice—it’s a necessity. Federal and state laws and industry guidance, including the Office of Inspector General (OIG) Compliance Program...more

Bond Schoeneck & King PLLC

Office of Medicaid Inspector General Releases Annual Workplan

On Jan. 29, 2025, the New York State of Office of Medicaid Inspector General released its Annual Workplan, to provide a guide for stakeholders for its 2025 activities. As in past years, the Workplan provides a roadmap for...more

Mintz - Health Care Viewpoints

EnforceMintz — Medicare Advantage and Part D Programs to Remain in the Enforcement Spotlight in 2025

As government scrutiny and enforcement targeting the Medicare Advantage (Medicare Part C) program continued in 2024, the industry’s response to agency actions escalated. Last year also resulted in the first sizable Part D...more

Health Care Compliance Association (HCCA)

[Event] 2023 Board & Audit Committee Compliance Conference - October 23rd - 24th, Fort Lauderdale, FL

Discover today's best practices for your role in healthcare compliance oversight - The Office of Inspector General of Health and Human Services expects healthcare board members, board audit/compliance committee members,...more

McDermott Will & Schulte

Healthcare Regulatory Check-up Newsletter | December 2022 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity between November 21 and December 31, 2022, including recent enforcement activity and a summary of the Office of Inspector...more

McDermott Will & Schulte

[Webinar] Provider Relief Fund Legal, Audit/Enforcement and Accounting Outlook - October 25th, 2:00 pm - 3:15 pm EDT

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Provider Relief Fund (PRF) Period 3 reports and the first independent audits (e.g., Single and Financial Audits) were due September 30. Recovery actions and enforcement activity are likely to follow and may be informed by...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2023 Managed Care Compliance Conference - January 31st - February 2nd, 8:25 am - 3:15 pm CT

Join us for our annual event dedicated to compliance management for health plan providers. Learn the latest best practices and emerging trends from industry leaders while making connections with peers and mentors who...more

Health Care Compliance Association (HCCA)

[Virtual Event] Indianapolis & Pittsburgh Regional Healthcare Compliance Conference - October 7th, 8:25 am - 4:30 pm EDT

General and specialty compliance training from the comfort of your home or office! HCCA’s Regional Healthcare Compliance Conferences provide practitioners with virtual compliance training that includes updates on the...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2022 Research Conference - October 6th, 8:25 am - 4:30 pm CDT

Stay on top of the latest in research compliance - Do you want to learn: - Current best practices for building and maintaining a  research compliance work plan? - How to better shift your program’s research focus in...more

Health Care Compliance Association (HCCA)

Telehealth regulatory oversight and enforcement trends

CT magazine (July 2022) - One of the notable impacts of the COVID-19 pandemic on the healthcare industry has been the boom in services provided via telehealth. This boom is in part due to temporary flexibilities applied...more

Health Care Compliance Association (HCCA)

[Event] Regional Healthcare Compliance Conference - August 5th, Philadelphia, PA

Looking for compliance training and networking in your area? HCCA’s Regional Healthcare Compliance Conferences offer practitioners convenient, local compliance training, including updates on the latest news in regulatory...more

Goodwin

Federal Audits and Enforcement Actions of Telehealth Providers: Future Trends and Mitigating Risk

Goodwin on

As the COVID-19 pandemic progresses and the expanded use of telehealth has appeared to stabilize over the past year according to a July report from McKinsey & Company, Federal agencies have continued the recent trend of...more

Foley & Lardner LLP

A Target on Telehealth: Government Action Against Telehealth Fraud in the Wake of COVID-19

Foley & Lardner LLP on

The COVID-19 Public Health Emergency (PHE) is expected to prompt unprecedented levels of regulatory enforcement activity that is focused on the use of telemedicine. In fact, fraudulent and abusive telehealth practices was an...more

King & Spalding

Principal Deputy Inspector General Grimm’s Speech On OIG’s Top 10 Priorities

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On April 19, 2021, HHS OIG Principal Deputy Inspector General Christi A. Grimm gave the keynote address at the Health Care Compliance Association’s 25th Annual Compliance Institute wherein she highlighted 10 key compliance...more

Sheppard Mullin Richter & Hampton LLP

Nota Bene Episode 84: Organizational Integrity in the Post-Pandemic Enforcement Environment

The coronavirus pandemic has proven to be the most significant business crisis in global history. What will it take for multinational companies to aptly respond to the crisis while managing potential future harm from the...more

Health Care Compliance Association (HCCA)

Report on Research Compliance Volume 17, Number 2. January 2020: In This Month’s E-News: February 2020

Report on Research Compliance 17, no. 2 (January 23, 2020) - - More than two years after Ozgur Tataroglu’s paper was retracted, the HHS Office of Research Integrity found that it and two grant applications contained...more

Health Care Compliance Association (HCCA)

[Event] Board & Audit Committee Compliance Conference - February 24th - 25th, Fort Lauderdale, FL

The Office of Inspector General of Health and Human Services expects board members, board audit/compliance committee members, and senior level leaders of organizations to be experienced in compliance oversight. The Board &...more

Baker Donelson

OIG Pushes OCR to Step Up HIPAA Enforcement

Baker Donelson on

In two recent reports, each with a specific focus, the OIG strongly recommended that the Office for Civil Rights (OCR) step up its HIPAA oversight and enforcement activities. One report assessed the OCR’s oversight of covered...more

Katten Muchin Rosenman LLP

Bridging the Week - August 2015 #4

CME Group Files Disciplinary Actions for Trading Ahead of Block Trades and Failure to Supervise an Employee Engaging in Disruptive Trading Activities - In two cases of first impression, CME Group exchanges brought and...more

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