Kusserow on Compliance: OIG reports 2016 mid-year work plan update: Items completed, revised, & removed

The HHS Office of Inspector General (OIG) released a mid-year update on its 2016 Work Plan that summarizes new and ongoing reviews and activities it plans to pursue with respect to HHS programs and operations during the current fiscal year and beyond. This report includes those items that have been completed, postponed, or canceled. The following list those items related to Medicare and Medicaid. It is worth reviewing to determine whether the outcomes noted have any effect on the current compliance office work plan. Details can be found in the Work Plan.

Items in the 2016 Work Plan Completed

  • Medicare Did Not Pay Select Inpatient Claims for Bone Marrow and Stem Cell Transplant Procedures in Accordance with Medicare Requirements
  • Hospices Inappropriately Billed Medicare Over $250 Million for General Inpatient Care
  • CMS Has Not Performed Required Closeouts of Contracts Worth Billions
  • National Background Check Program for Long-Term-Care Employees: Interim Report
  • Enhanced Enrollment Screening Process for Medicare Providers: Early Implementation Results.
  • Part B Payments for 340B Purchased Drugs

Revised Work Plan Items

  • Consumer Operated and Oriented Plan Loan Program—CO-OP Conversion of Start-up Loans and CMS Monitoring Activities
  • CMS Oversight of Eligibility Determinations at State-Based Marketplaces
  • Medical Loss Ratio

Work Plan Items Removed

  • Analysis of Generic Price Increases Compared to Price Index

Richard P. Kusserow served as DHHS Inspector General for 11 years. He currently is CEO of Strategic Management Services, LLC (SM), a firm that has assisted more than 3,000 organizations and entities with compliance related matters. The SM sister company, CRC, provides a wide range of compliance tools including sanction-screening.

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Copyright © 2016 Strategic Management Services, LLC. Published with permission.