Mid Year Update to the OIG 2016 Work Plan
The Office of Inspector General (OIG) released a mid-year update to its 2016 Work Plan which includes several new reviews of the OIG plans to begin in the near future, and just as many revisions to ongoing reviews, in nearly every sector. The agency tasked with detecting Medicare fraud, waste, and abuse also lists reviews it has completed or removed since releasing the initial OIG 2016 Work Plan.
What will be new for Medicare Parts A and B:
The OIG will initiate the following new reviews:
? Outpatient Outlier Payments for Short-Stay Claims
? Intensity-Modulated Radiation Therapy (IMRT)
? Skilled Nursing Facility Prospective Payment System Requirements
? National Background Checks for Long-Term Care Employees
? Potentially Avoidable Hospitalizations of Medicare and Medicaid Eligible Nursing Home Residents for Urinary Tract Infections
? Accountable Care Organizations: Beneficiary Assignment and Shared Savings Payments
? Medicare Home Health Fraud Indicators
? CMS? Implementation of New Medicare Payment System for Clinical Diagnostic Laboratory Tests
Revised Ongoing Reviews:
? Medicare Oversight of Provider-Based Status
? Analysis of Salaries Included in Hospital Cost Reports
? Home Health Prospective Payment System Requirements
? Histocompatiblity Laboratories ? Supplier Compliance with Payment Requirements
? Covered Uses for Medicare Part B Drugs
? Inpatient Rehabilitation Facility Payment System Requirements
Completed Reviews:
? Medicare Did Not Pay for Selected Inpatient Claims for Bone Marrow and Stem Cell Transplant Procedures in Accordance with Medicare Requirements which was issued in February 2016.
? Hospices inappropriately billed Medicare over $250 Million for general inpatient care which was issued in March 2016.
? CMS has not performed required closeouts of contracts worth billions which was issued in December 2015.
? National Background Check Program for Long-Term Care Employees: Interim Report which was issued in January 2016.
? Enhanced Enrollment Screening Process for Medicare Providers: Early Implementation Results issued in April 2016.
? Part B Payments for 340B Purchased Drugs issued in November 2015.
Removed Reviews:
? Imaging Services: Payments for Practice Expenses.
? End-Stage Renal Disease Facilities: Payment System for Renal Dialysis Services and Drugs.
? Contract Management at the Centers for Medicare & Medicaid Services.
? Review the entire mid-year updated work plan for details on these and other Medicare Parts A and B issues.