The new OIG Medicare Advantage ICPG highlights seven major risk areas and offers practical guidance MA Parties can use to strengthen oversight, reduce exposure, and support better compliance decisions.
The HHS OIG has released its long-awaited Medicare Advantage Industry Segment-Specific Compliance Program Guidance (ICPG), giving MAOs and other MA Parties a new voluntary resource for identifying and managing program-specific compliance risks.
The guidance complements the OIG’s General Compliance Program Guidance and CMS’s required compliance program regulations. While not binding, it reflects years of OIG oversight and offers practical recommendations tied to real risk.
Our latest eBrief focuses on Section II, where OIG outlines seven core risk areas for MA Parties:
- Access to care
- Marketing and enrollment
- Risk adjustment
- Quality of care
- Oversight of third parties
- Vertically integrated and other ownership structures
- Submission of accurate claims
Read the article for a practical breakdown of the risks and mitigation steps MA organizations should be considering now.