OIG Releases Fiscal Year 2017 Work Plan.
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently released its fiscal year (FY) 2017 Work Plan. The OIG outlines new and ongoing reviews of HHS programs and operations in its annual Work Plan. For each review, the Work Plan provides an internal identification code and the year in which the OIG expects to issue results. The OIG reviews various providers, including hospitals, nursing homes, and home health services.
Notable OIG Work Plan items for FY 2017 include:
- Incorrect medical assistance days claimed by hospitals (addressing risk of overpayment under the Medicare disproportionate share hospital payments);
- Case review of inpatient rehabilitation hospital patients not suited for intensive therapy;
- Inpatient psychiatric facility outlier payments;
- Medicare costs associated with defective medical devices;
- Unreported incidents of abuse and neglect in skilled nursing facilities;
- Skilled nursing facility reimbursement;
- Review of hospice compliance with Medicare requirements;
- Medicare payments for transitional and chronic care management;
- Medicare Payments for Service Dates After Individuals’ Date of Death;
- Center for Medicare & Medicaid Services (CMS)’ implementation of the Quality Payment Program;
- Medicare Part D rebates for drugs dispensed by 340B pharmacies;
- Medicaid overpayment reporting and collections; and
- CMS oversight and issuer compliance in ensuring data integrity for the Affordable Care Act (ACA) Risk Adjustment Program.
Providers should examine the entire OIG Work Plan and review risk areas that may prompt OIG enforcement actions.
The 2017 OIG Work Plan is available at:
Department of Health and Human Services Office of Inspector General. “Work Plan for Fiscal Year 2017.” Work Plan. 10 Nov. 2016.