Compliance Partner Insights 

If you’ve ever sat in a leadership team meeting where someone says: “We need a compliance program” and everyone nods without quite agreeing on what that means, you’re not alone. The good news is that the OIG has provided excellent resources to help including the General Compliance Program Guidance+ that lays out seven elements every effective compliance program should have. None of them are complicated. Here they are in plain terms. (1) Written Policies and Procedures. Not a

In a significant False Claims Act settlement, Oglethorpe Inc., a Florida-based operator of psychiatric hospitals, along with its founder and two top executives, agreed to pay $32 million to resolve allegations that they knowingly failed to return Medicare overpayments. The overpayments were tied to patients admitted to behavioral health facilities in Ohio who did not qualify for inpatient psychiatric care. The case originated as a qui tam lawsuit filed by four former Ogletho

Let's be honest — when someone mentions "compliance program," healthcare organization C-Suite members also think “cost center.” But here's the thing: an effective compliance program is really your organization's early warning system. Think of it as a smoke detector: nobody brags about owning one, but everyone's grateful it's there when things get smoky. Federal enforcement of healthcare fraud, waste, and abuse has never been more active, more sophisticated, or more varied in

The Office of Inspector General for the U.S. Department of Health and Human Services submitted its FY 2027 budget request — and the numbers demand attention. The OIG is requesting $446.7 million in total funding: $362.5 million dedicated to Medicare and Medicaid oversight, and $84.2 million covering HHS public health, human services, science, and regulatory programs. The mission is explicit: prevent fraud, detect waste and abuse, and drive program efficiency. The OIG's FY 20

The federal government recently sent a clear message to the healthcare industry: fraud enforcement is expanding, and it means business. The Justice Department's National Fraud Enforcement Division recently announced the formation of the West Coast Health Care Fraud Strike Force, a multi-district initiative collaborative of federal prosecutors across Arizona, Nevada, and Northern California. This isn't a new concept — it's a proven one. The Health Care Strike Force model has a