OIG Work Plan guides written for administrators and compliance officers who read regulatory documents, not just summaries of them. Verbatim OIG language, specific dollar exposure, and concrete corrective actions — organized as professional references, not checklists.
Each guide draws verbatim OIG Work Plan language, maps active audit items to specific billing codes and documentation requirements, and provides concrete corrective action language. These are compliance program reference documents — not executive summaries.
Independent behavioral health, psychology, and psychiatric practices billing Medicare/Medicaid
Covers the full OIG Work Plan audit surface for mental health providers — psychotherapy session documentation, E/M leveling in psychiatric settings, telehealth billing post-PHE, and the documentation requirements that generate the highest overpayment rates in behavioral health claims.
Independent and small-chain home health agencies operating under Palmetto JM HHH
HHA-specific OIG audit priorities for 2026 — face-to-face encounter documentation, OASIS-E2 transition compliance, PDGM coding integrity, and the Reason Code 56900 denial pattern that accounts for nearly half of all Palmetto HHA denials. Written for HHA administrators and compliance officers.
Solo and small-group primary care, DPC, and internal medicine practices billing Medicare
The highest-density OIG audit surface of any specialty. E/M level distribution, AWV documentation, CCM billing, modifier 25 same-day frequency, and split/shared visit billing under the 2024 rule revision. Includes a section on the voluntary repayment framework and self-disclosure positioning for overcoding findings.
Independent hospice operators — especially those operating under Palmetto JM HHH or in PPEO states
The 2026 OIG Work Plan items most directly affecting independent hospice operators: GIP documentation and level-of-care appropriateness, aggregate cap exposure mechanics, election statement and Addendum compliance, HOPE implementation, and the PPEO prepayment review posture. Written against 42 CFR Part 418 and Palmetto LCD L38655.
Medical spas and aesthetic practices billing any Medicare-reimbursable services
The medspa compliance landscape is unusually complex: LegitScript certification, GCMB Nurse Protocol Agreement requirements under O.C.G.A. § 43-34-25, Cosmetic Laser Services Act compliance, and OIG audit exposure on any Medicare-reimbursable services billed alongside aesthetic procedures. This guide covers the full intersection. In production — email hello@prognosisconsulting.com to be notified at launch.
Every audit item is quoted from the OIG Work Plan using the exact language the OIG uses — not a paraphrase. When an auditor cites a Work Plan item in a findings letter, you'll recognize the language because you've already read it in the guide.
Where OIG prior audit reports include overpayment rates or dollar amounts, those figures are incorporated. A compliance officer who can attach a dollar figure to a risk item gets a board conversation. A compliance officer with a checklist does not.
Each audit item includes a corrective action section with specific policy and procedure language that can be adapted directly into a compliance program. The guides are designed to reduce the gap between "we identified a gap" and "we fixed it."
The post-acute guides (hospice, home health) incorporate Palmetto GBA JM HHH-specific positions, LCD references, and TPE edit patterns. National OIG guidance is the floor; what Palmetto is actually denying in Georgia is the ceiling.
Formatted as a compliance officer or administrator would write an internal reference document — not a vendor white paper. No marketing language, no upsell in the footnotes. The guide is the product.
Benchmarked against the OIG's continuously updated Work Plan as of early 2026 — not a prior year's edition. Where the Work Plan has been updated since the guide was written, a revision is issued.
Every guide includes a soft pathway to the consulting engagement that validates its findings at the claims level. A guide tells you what to look for; an audit tells you what's actually there. Most guide buyers who have the relevant exposure schedule an engagement within 60 days.
If you read the guide and recognized something specific — a documentation pattern, a billing frequency, a workflow gap — that's the signal to schedule a discovery call. We can scope the right engagement from there.
Schedule a Discovery Call →The OIG Work Plan updates continuously. New guides are added as we complete them — Medspa is next in queue, followed by SNF and staffing agency editions. Follow us on Gumroad to be notified at launch, or email us to be added to a specific guide's notification list.