For entities entering a CIA, it is important to ensure that the scope and breadth of the agreement is clearly defined and specifically defined. In most cases, compliance and requirement checks are fairly straight forthcoming as long as the parameters for what constitutes an “error” are defined in advance. However, in some cases, ASCI are designed in response to alleged problems or misconduct that require program evaluations and controls rather than claims audits. Before entering into a final agreement with the CIA, it is advisable to have an expert who helps you ensure that the CIA`s terms are clear and that the scope and objectives of the IRO are also clearly defined. Some CIAs require an independent organization to verify and monitor compliance with the CIA`s terms and conditions. Most ASCI require damage checks to identify errors and their underlying causes.  The government authority may verify compliance through on-site visits.  If a company violates the agreement, the Agency can sanction it and if the problems cannot be resolved, the supplier can be excluded.  This article contains public service information from the U.S. Department of Health and Human Services document: “Corporate Integrity Agreements Snapshot” (PDF). Retrieved April 14, 2018.
While compliance is complicated and typically costly, OIG Corporate Integrity Agreements leads companies through the implementation of an effective healthcare compliance program, which ultimately results in regular billing practices. Failure to comply with the terms of the OIG Corporate Integrity Agreement may result in additional sanctions, extension of CIA terms, or exclusion. Because the HHS Office of Inspector General`s goal is to investigate fraud and abuse against the Medicare and Medicaid programs, it has the power to enter into settlement negotiations to avoid criminal complicity of healthcare providers for fraud and abuse. . . .