Compliance Resources

Federal Regulations & Compliance

Federal compliance guidance, regulatory references, advisory materials, and oversight resources.

Reference standard: Confirm the current effective date and applicability of each source before relying on it for an audit finding, coding decision, provider education, or compliance determination.

HHS OIG Compliance Resources

Central access to OIG compliance guidance and related oversight materials.

  • General Compliance Program Guidance
  • Corporate Integrity Agreements
  • Single Audit resources
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General Compliance Program Guidance

Voluntary OIG guidance addressing general compliance risks and the elements of an effective compliance program.

  • Compliance program infrastructure
  • Risk assessment and auditing
  • Education, communication, and corrective action
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OIG Advisory Opinions

Official OIG opinions concerning application of fraud-and-abuse authorities to specific arrangements.

  • Current and archived opinions
  • Request information and procedures
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OIG Fraud Alerts and Bulletins

Special Fraud Alerts, advisory bulletins, and other guidance identifying compliance risk.

  • Fraud alerts
  • Special advisory bulletins
  • Other compliance guidance
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Corporate Integrity Agreements

OIG agreements used to strengthen compliance programs following certain federal healthcare settlements.

  • Current CIAs
  • Agreement requirements and oversight
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CMS Code Sets

CMS overview of HIPAA-adopted code sets used in standard healthcare transactions.

  • ICD-10-CM and ICD-10-PCS
  • CPT and HCPCS
  • National Drug Codes
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