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Updated Compliance Program Guidance for Nursing Facilities

Compliancy Group

The Office of Inspector General (OIG) released an updated Nursing Facility Industry Compliance Program Guidance (ICPG) in November 2024 to assist nursing facilities in navigating the complex regulatory landscape and mitigating compliance risks.

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Breaking Down the OIG’s First Industry-Specific Guidance 

YouCompli

The HHS OIG recently issued its first Industry Segment-Specific Compliance Program Guidance, or ICPG , with many more expected. When a nursing facility submits a claim to Medicare or Medicaid for reimbursement, it certifies the services were provided in compliance with all applicable statutes, regulations, and rules. CJ Wolf, MD, M.Ed.

Nurses 52
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Compliance Risks Associated with Outlier Payments 

YouCompli

Raising prices on your hospital’s chargemaster can also raise your level of compliance grief. Price increases can sometimes result in inappropriate outlier payments. This is why Medicare publishes its rules on their Inpatient Prospective Payment System (IPPS) or its Outpatient Prospective Payment System (OPPS).

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Enhancing Payment Integrity in Healthcare through Pre-Payment Reviews

Healthcare IT Today

This quote lies at the heart of integrity, a powerful concept that applies equally critically in the healthcare payments environment as it does in daily life. Payers battle administrative overload caused by reconciling inaccurate payments and reprocessing claims to pay the accurate reimbursement amount.

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OIG Issues Highly Anticipated Industry Segment-Specific Compliance Program Guidance for Nursing Facilities

Hall Render

Department of Health and Human Services (“HHS”) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (“Nursing Facility ICPG”) for nursing home members of the health care compliance community. On November 20, 2024, the Office of Inspector General (“OIG”) for the U.S.

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