• videocam Live Webinar with Live Q&A
  • calendar_month May 5, 2026 @ 1:00 PM ET/10:00 AM PT
  • signal_cellular_alt Intermediate
  • card_travel Health
  • schedule 90 minutes

OIG Modernized Medicare Advantage Compliance Guidance: Key Updates, Provider Risks, Evaluating Compliance Programs

About the Course

Introduction

This CLE webinar will provide a comprehensive examination of the Department of Health and Human Services, Office of Inspector General's (OIG) recently released and long-awaited Medicare Advantage Industry Segment-Specific Compliance Program Guidance (MA ICPG or guidance). The panel will examine the seven compliance risk areas addressed in the guidance, review OIG's recommendations for mitigating those risks, and offer best practices for remaining compliant.

Description

OIG recently released its highly anticipated Medicare Advantage ICPG, the first update in 27 years. The new guidance outlines seven compliance risk areas for those engaging with or participating in Medicare Advantage, provides recommendations and practical considerations for mitigating those risks, and offers other important information that OIG believes covered parties should consider when implementing, evaluating, and updating their compliance programs.

The key risk areas identified and addressed by OIG are: (1) access to care; (2) marketing and enrollment; (3) risk adjustment; (4) quality of care; (5) oversight of third parties; (6) compliance programs within vertically integrated organizations and other ownership structures; and (7) submission of accurate claims.

Listen as our expert panel examines OIG's long-awaited MA ICPG guidance and breaks down the various risk areas and what counsel and their covered healthcare clients need to know to mitigate risks of noncompliance.

Presented By

Elinor A. Hiller
Partner
Alston & Bird LLP

Ms. Hiller focuses her practice on regulatory and legislative issues concerning health care payers, providers, and manufacturers. She has experience representing clients across the health care industry on policy matters, with a focus on Medicare Advantage and Part D, Medicare fee-for-service payment rules, interoperability and price transparency, and federal insurance oversight. Ms. Hiller previously served at the Centers for Medicare & Medicaid Services (CMS), where she was most recently the administrator’s senior advisor for Medicare. She advised the administrator and other senior agency officials on all parts of Medicare and also led initiatives related to health care price transparency. Earlier in her time at CMS, Ms. Hiller was the director of the Medicare Parts C and D Analysis Group in the Office of Legislation, where she managed interactions between the agency and Capitol Hill on a portfolio of issues including provider integrity. From the Office of Legislation, she worked closely with staff for the Senate Finance, House Ways & Means, and House Energy & Commerce Committees on legislative priorities and Administration policy.

Heidi A. Sorensen
Counsel
Alston & Bird LLP

Ms. Sorensen builds on her previous experience at the Office of Counsel to the Inspector General of the Department of HHS to assist clients with health care regulatory, compliance, and fraud and abuse matters. She focuses her practice on health care fraud and abuse and compliance matters, including the Anti-Kickback Statute. Ms. Sorensen assists clients in False Claims Act investigations, negotiating FCA settlements and corporate integrity agreements, and matters that fall under the Civil Monetary Penalties Law and OIG exclusion authorities. She helps clients develop compliance programs and implement corporate integrity agreements. Ms. Sorensen previously served as chief of the Administrative and Civil Remedies Branch in the Office of Counsel to the Inspector General (OCIG) at HHS. She served as the OCIG’s coordinator for both the Provider Self-Disclosure Protocol and the Physicians at Teaching Hospitals national project and also served the OCIG as senior counsel and deputy branch chief.

Credit Information
  • This 90-minute webinar is eligible in most states for 1.5 CLE credits.


  • Live Online


    On Demand

Date + Time

  • event

    Tuesday, May 5, 2026

  • schedule

    1:00 PM ET/10:00 AM PT

I. Introduction 

II. Updated MA ICPG

A. Purpose

B. Covered entities

C. Risk areas

D. OIG recommendations for mitigating risks

E. Evaluating, updating, and implementing compliance programs

III. Key takeaways

The panel will review these and other important considerations:

  • How have technology and other changes in the healthcare industry driven the need for updated MA ICPG guidance?
  • What are the seven risk areas on which OIG focuses in the MA ICPG? Why?
  • What are OIG's recommendations for risk management?
  • What MA-specific considerations does OIG offer for compliance program structure and operations?