Alerts2.9.26
HHS-OIG Issues Medicare Advantage Industry Segment-Specific Compliance Program Guidance
Highlights
- The U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) released the Medicare Advantage Industry Segment-Specific Compliance Program Guidance (Medicare Advantage ICPG) in February 2026, the second ICPG in HHS-OIG’s planned series announced in November 2023.
- This is the first update to Medicare Advantage (MA)-specific compliance guidance from HHS-OIG in over 26 years, reflecting the recent rapid growth of the MA program, which now includes more than half of all Medicare beneficiaries and accounts for the largest share of Medicare spending.
- OIG identifies the following key risk areas for Medicare Advantage Organizations (MAOs) and those engaging with the MA program: access to care, marketing and enrollment, risk adjustment, third party oversight, and data integrity.
In Feb. 2026, HHS-OIG issued the Medicare Advantage ICPG, providing updated recommendations for compliance programs across the MA sector. This guidance is intended for a broad array of stakeholders, including MAOs, healthcare providers, agents, brokers, vendors, and other entities engaged in the MA program (collectively, MA Parties).
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