A corporate integrity agreement sets out the terms under which the Office of the Inspector General requires compliance with the conditions it sets out for healthcare providers/entities to facilitate settlement of civil false claims.
A corporate integrity agreement is an agreement that the Office of the Inspector General (OIG), which comes under the US Department of Health and Human Services (HHS), negotiates with healthcare provider/entity and related entities. This agreement is carried out for facilitating the settlement of Federal health care program investigations into civil false claims statutes.
A corporate integrity agreement requires providers/entities to inform the payor if any overpayments have been identified and made, and must also reimburse the overpaid amount as set out in the terms of the payor's policies.
As part of this corporate integrity agreement, a provider/entity comes to an agreement as to their obligations. In return, the OIG on its part gives them the understanding that they will not be excluded from participating in Federal health care programs such as Medicare, Medicaid and others. A corporate integrity agreement thus is a contract between the OIG and provider/entity to contain the consequences of false claim statutes.
Most corporate integrity agreements signed with different provider/entity carry many common features. New changes required into a fresh agreement are brought in into a new agreement wherever these are necessary. The normal term of a comprehensive corporate integrity agreement is five years.
As mentioned, the requirements of most corporate integrity agreements are common, unless drastic changes are warranted with a particular provider/entity. In general, these are the expectations or requirements that a corporate integrity agreement has from provider/entity: