OIG Releases Updated Guidance on IRO Independence and Objectivity for Performing Corporate Integrity Agreement Reviews

The U.S. Department of Health and Human Services Office of Inspector General (OIG) released today, August 24, 2016, an updated guidance on the OIG’s views on the applicable independence and objectivity standards for Independent Review Organizations (IROs) that perform reviews required under Corporate Integrity Agreements (CIAs), such as claims reviews and cost report reviews. The OIG has previously issued guidance in 2004 and 2010 to reflect updated standards and the additional types of IRO reviews included in CIAs. This OIG guidance released today is to reflect the 2011 revisions to the GAO accounting standards.

Health care providers and other entities often enter into CIAs as a result of a settlement with the OIG related to allegations of violating certain civil false claims statutory provisions. Health care providers or entities agree to certain obligations in a CIA, including retaining an independent review organization to conduct annual reviews.

A copy is available on the OIG’s website at www.oig.hhs.gov

Written by: Clay J. Countryman

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