OIG Compliance Program
Voluntary compliance program structure recommended by HHS-OIG for physician practices.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Compliance Program
- Primary sources
- 2
- Workspace handoff
- compliance binder →
Where this comes up
Compliance committees and practice managers operate at this level — written policy, workforce training, sanction policy, monitoring and auditing cadence, response and corrective action. The seven elements of an effective compliance program (OIG) are the scaffolding; this term lives somewhere on that scaffold.
Full definition
What it is in practice
HHS-OIG Compliance Program Guidance for Individual and Small Group Physician Practices outlines seven elements: written policies, designated compliance officer, training, communication, monitoring/auditing, response/corrective action, and enforcement/sanctions.
How it shows up in your practice
Even small practices benefit from documenting all seven elements. A documented program is a mitigating factor in OIG/DOJ enforcement.
Sources
- HHS-OIG — Compliance Program Guidancehttps://oig.hhs.gov/documents/compliance-guidance/812/physician.pdf
- HHS-OIG General Compliance Program Guidance 2023https://oig.hhs.gov/compliance/general-compliance-program-guidance/
Adopt the OIG seven-element program in the Compliance Binder
Open compliance binder →Related terms
- EnrollmentLEIE Exclusion ScreeningMonthly screening of staff and vendors against the HHS-OIG List of Excluded Individuals/Entities (LEIE).
- Compliance ProgramFalse Claims ActFederal statute (31 USC 3729-3733) that imposes liability on persons and companies who defraud federal programs.
- Compliance ProgramAnti-Kickback Statute (AKS)Federal criminal statute (42 USC 1320a-7b(b)) that prohibits offering, paying, soliciting, or receiving remuneration to induce or reward referrals for items or services payable by federal health programs.
- Compliance ProgramStark LawFederal statute (42 USC 1395nn) prohibiting physicians from referring Medicare/Medicaid patients for designated health services to entities with which the physician has a financial relationship, unless an exception applies.
- Compliance ProgramCompliance OfficerThe designated individual responsible for operating the practice's compliance program.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryCompliance OfficerThe designated individual responsible for operating the practice's compliance program.
- GlossaryAnti-Kickback Statute (AKS)Federal criminal statute (42 USC 1320a-7b(b)) that prohibits offering, paying, soliciting, or receiving remuneration to induce or reward referrals for items or services payable by federal health programs.
- GlossaryFalse Claims ActFederal statute (31 USC 3729-3733) that imposes liability on persons and companies who defraud federal programs.
- GlossaryStark LawFederal statute (42 USC 1395nn) prohibiting physicians from referring Medicare/Medicaid patients for designated health services to entities with which the physician has a financial relationship, unless an exception applies.
- GlossaryLEIE Exclusion ScreeningMonthly screening of staff and vendors against the HHS-OIG List of Excluded Individuals/Entities (LEIE).
- ComplianceThe OIG's 7 Elements of an Effective Compliance Program (Applied to a Small Practice)The OIG's seven elements of an effective compliance program, what each one looks like in a 1–15-clinician practice, and how to document each in 2026.
- GlossaryCivil Monetary PenaltiesAdministrative penalties HHS-OIG may impose on healthcare providers for various violations including HIPAA breaches, kickbacks, and billing for excluded individuals.
- BillingWhat to Do When a Payer Says You're UnderbillingGot a letter saying you're underbilling? Here's what it actually means, whether you should worry, and what action to take.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.