General OIG Compliance Program Guidance

These flashcards cover key terms and concepts related to the Office of Inspector General's compliance program guidance.

OIG General Compliance Program Guidance (GCPG)

A guidance document from the Office of Inspector General that provides key compliance elements for entities in the healthcare industry.

Seven Elements of Compliance Program

The foundational components necessary for an effective compliance program as defined by the OIG.

Healthcare Compliance Association (HCCA)

An association dedicated to promoting compliance and ethics in the healthcare industry.

Corporate Integrity Agreement (CIA)

An agreement negotiated between the OIG and healthcare providers, often as a settlement for compliance violations.

Fraud, Waste, and Abuse (FWA)

Categories of improper conduct that involve deception or misuse of resources within healthcare programs.

Self-Referral Law (Stark Law)

Federal law that prohibits physicians from referring patients to facilities in which they have a financial interest.

Anti-Kickback Statute (AKS)

A federal law that prohibits the exchange of remuneration for patient referrals in federally funded programs.

Incident Reporting

The process of documenting and addressing occurrences that may breach compliance guidelines.

Compliance Officer

An appointed individual responsible for the implementation and oversight of the compliance program within a healthcare organization.

Training and Education

Programs designed to inform staff about compliance policies, procedures, and applicable laws.

Written Policies and Procedures

Formal documents outlining compliance standards and operational protocols for a healthcare organization.

Auditing and Monitoring

The ongoing processes of reviewing compliance with regulations and practices to ensure adherence to established standards.

Non-Retaliation Policy

A policy that protects employees from adverse actions when they report compliance issues in good faith.

Corrective Action Plan (CAP)

A structured plan developed to address compliance violations and prevent future occurrences.

Risk Assessment

The systematic identification and analysis of risks associated with compliance in a healthcare organization.

Adaptations for Small and Large Entities

Guidance provided by the OIG recognizing the varying capacities and resources of different sized healthcare organizations.