Compliance Tip of the Day: Assessing Internal Controls
Compliance Tip of the Day: COSO Objective 5 – Monitoring Activities
Hospice Insights Podcast - Election Inspection: Be Proactive to Avoid Costly Election Statement Denials
Compliance Tip of the Day: COSO Objective 3 – Control Activities
FCPA Compliance Report: Fraud Risk Management - Insights and Experiences with Peter Schablik
Hot Topics in International Trade - Let's Be Serious-Supply Chain Audits
Workplace ICE Raids Are Surging—Here’s How Employers Can Prepare - #WorkforceWednesday® - Employment Law This Week®
REFRESH Five Tax Traps for Business Lawyers Advising Nonprofit Organizations
Hospice Insights Podcast - Hospice Audit Updates: David Beats Goliath
Compliance Tip of the Day: Middle Managers as the Eyes and Ears of Compliance
Episode 365 -- Four Sanctions Cases Everyone Should Know
UPIC Audits
Compliance Tip of the Day: The role of Compliance in Auditing AI
California Employment News: Taking Advantage of the PAGA Reform – How Employers Can Lower Their Risk of PAGA Liability
Auditing Your Hotline and Case Management System
Hospice Insights Podcast - Controlling the Narrative: A New Tactic for Auditors and ALJs
Improving Your Code of Conduct
Now Is the Time to Conduct I-9 Audits: What's the Tea in L&E?
Preparing for — and Surviving — an OFCCP Audit
Hospice Insights Podcast - Meet the New Laws, Same as the Old Laws: Overpayment Recoupment Update
In June 2025, the U.S. Department of Health and Human Services Office of Inspector General (OIG) announced a new item in its Work Plan: “Medicare Payments for Clinical Diagnostic Laboratory Tests in 2024.” This annual review,...more
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
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
On May 27, 2025, HHS Office of Inspector General (OIG) issued a report outlining its finding that Medicare payments for evaluation management (E&M) services provided on the same day as eye injections were at risk for...more
Grounded in the OIG’s General Compliance Program Guidance and DOJ’s Evaluation of Corporate Compliance Programs, our immersive, three-and-a-half-day, classroom-style Healthcare Basic Compliance Academy equips compliance...more
Hospice audits can have profound financial implications, particularly when the auditors use statistical extrapolation to identify an overpayment amount. The use of extrapolation runs across auditor types, including UPICs and...more
The 12 regional Medicare Administrative Contractors (MACs) were recently audited by the U.S. Department of Health and Human Services’ Office of Inspector General (OIG). Each of the MAC jurisdictions was found by the OIG to...more
Last week, OIG’s Office of Audit Services released its latest report on Medicare Administrative Contractors’ (MACs) compliance with Medicare cost report oversight requirements. The report, which is titled Medicare...more
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
On January 29, the New York State Office of the Medicaid Inspector General (OMIG) published its 2025 Work Plan, which provides a preview of the OMIG’s program integrity initiatives for the upcoming year. While this post...more
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
On January 3, 2025, OIG posted the results of an audit that found that Medicare could have saved $7.7 billion if critical access hospitals’ (CAH) payments for swing-bed services were similar to those of the fee-for-service...more
Secretary of Defense nominee Pete Hegseth testified during his confirmation hearing on January 14, 2025, that if confirmed*, he intends to use audits to identify potential waste and abuse in defense spending, explaining that...more
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
On December 4, 2024, OIG issued its fall 2024 Semiannual Report to Congress (the Report), which provides a comprehensive overview of the agency’s work completed during the reporting period of April 1, 2024, through September...more
Recognizing the increasing number of successful cyberattacks targeting health care organizations and their valuable patient data, the Office of the Inspector General (OIG) is calling for enhancements to the HIPAA audit...more
The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) is required by law to perform periodic audits of covered entities and business associates to ensure their compliance with HIPAA Security Rule...more
On November 12, 2024, OIG published a report concluding that the Medicare program overpaid acute-care hospitals an estimated $190 million over five years for outpatient services provided to hospice enrollees....more
Earlier this month, OIG’s Office of Audit Services released its latest report on providers’ compliance with the Hospital Price Transparency Rule (the HPT Rule). The HPT Rule requires hospitals to make public (1) a...more
Report on Research Compliance 21, no. 9 (September, 2024) - Based on their review of public data on ClinicalTrials.gov, a bipartisan quartet of U.S. representatives has asked the Food and Drug Administration (FDA) to...more
On August 12, 2024, OIG announced the results of an audit of payments made to hospitals for inpatient claims with the Medicare Severity Diagnosis-Related Groups (MS-DRGs) that require ninety-six hours of consecutive...more
The OIG, the nation’s leader in fighting fraud, waste and abuse of Medicare, Medicaid and other HHS programs, periodically publishes reports on how federal healthcare programs could improve....more
Although most health care lawyers and compliance officers who review and analyze physician compensation understand that fair market value (FMV) is important, the nuances around FMV are sometimes missed....more
On April 22, 2024, the Office for Civil Rights (OCR) for the United States Department of Health and Human Services issued a Final Rule amending the Privacy Rule of the Health Insurance Portability and Accountability Act...more
In recent testimony before the United States House Committee on Energy and Commerce Subcommittee on Oversight and Investigations, Christi A. Grimm, Inspector General of the Department of Health and Human Services (HHS)...more