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Topic:
What is Corporate Integrity Agreement and Why it is Negotiated
Coursework Instructions:
Explain what a corporate integrity agreement (CIA) is and why it’s negotiated. Then, identify the criteria the Office of the Inspector General (OIG) uses to consider whether or not to propose a CIA with a provider, and discuss what will happen if a provider breaches the terms of a CIA. (50 points) (A 2-page response is required.)
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Explain what a corporate integrity agreement (CIA) is and why it is negotiated. Then, identify the criteria the Office of the Inspector General (OIG) uses to consider whether or not to propose a CIA with a provider, and discuss what will happen if a provider breaches the terms of a CIA
A Corporate Integrity Agreement (CIA) defines the obligations a corporate provider consents to as part of a civil settlement. CIA is an effective enforcement tool used by the U.S. Department of Health and Human Services, Department of Justice, and Office of Inspector General to combat health care fraud and abuse. CIA creates a framework where a corporate provider and its employees or stakeholders can operate to avoid being excluded from engagement with U.S federal healthcare programs. CIA is needed in circumstances when healthcare providers would like to engage in federal healthcare programs, and the desired level of quality and compliance is necessary.
Thus, the CIA allows corporate entities to participate in federal health care programs by signing an agreement that would deter corporates for their employers or affiliates from engaging in fraud or abuse while participating in Medicare or any other federal healthcare program. When the CIA is in force, the providers are obligated to implement training programs amongst its employees, make confidential disclosures projects, establish standards and policies, and deploy compliance officers when agreed items are violated (Bentivoglio, 2018). Furthermore, CIA frameworks manage and report specific events such as overpayments, existing legal proceedings, or ineligible contracting, among other possible contraventions.
The Office of the Inspector General (OIG) finds the CIA to be a handy tool. The OIG's purpose for negotiating CIA is to ensure that the identified misconduct, which can include false claims, improper arrangements, and misleading marketing, doesn't reoccur (Bentivoglio, 2018). OIG negotiates and monitors these agreements, which are often designed to last five years. With the CIA, providers or corporates must agree and comply with the defined obligations encapsulated in the CIA. However, in exchange, the OIG will not exclude the organizations entering the CIA from participating in Federal health care programs. CIA allows the providers or corporates to retain an Independent Re...
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