OIG Will Engage in Unannounced Site Visits to Ensure Compliance With CIAs

On April 23, the Department of Health and Human Services, Office of Inspector General (OIG), indicated that it will begin engaging in unannounced site visits to providers operating under corporate integrity agreements (CIAs). Specifically, in a speech at the Health Care Compliance Association’s 11th Annual Compliance Institute, Felicia Heimer, deputy chief in the Administrative and Civil Remedies Branch of the Office of Counsel to the OIG, said that OIG officials will engage in unannounced onsite visits. The purpose of the visits is to review documentation and tour facilities to determine whether providers are complying with CIA obligations.

Ms. Heimer explained that site visits are generally conducted randomly, but certain red flags will also give rise to an OIG visit. These include (1) tips from an employee or employees that the CIA is not being accurately followed, (2) lack of communication from the providers, and (3) missed deadlines in reporting information absent a request from the provider for an extension.

Where a violation is found, the OIG may assess the stipulated, non-negotiable penalties included in the CIA. Ms. Heimer explained that the OIG weighs several factors in determining whether to assess penalties, including the reason for the breach, how OIG learned of the breach, whether and how the provider corrected the problem, the seriousness of the offending conduct, and the extent of the provider’s compliance with other provisions of the CIA.