OIG Annual Work Plan for 2017 – Topics Covered
The Health and Human services Office of Inspector General (OIG) recently released its 2017 Annual Work Plan. Work planning is an ongoing project within the OIG. Every year, the OIG publishes a work plan that consolidates the OIG audits and evaluations that are being conducted or planned within the organization. The annual work plan has become a source that compliance officers look to as a tool for the identification of potential risk areas or areas of emphasis within their organization. It is obviously not the only source for identifying compliance risk areas, but is certainly one reliable source that providers can draw on when setting their annual compliance priorities.
The 2017 OIG Work Plan can be download through the OIG site.
Ruder Ware’s health care group will continue to put out blogs and articles on various issues identified in the 2017 Annual Work Plan. We will focus primarily on issues that were introduced for the first time in this year’s plan.
A listing of some of the issues addressed in the 2017 annual work plan include:
Hyperbolic Oxygen Therapy Services – Provider Reimbursement in Compliance with Federal Regulations
Incorrect Medical Assistance Days Claimed by Hospital
Inpatient Psychiatric Facility Outlier Payments
Case Review of Inpatient Rehabilitation Hospital Patients Not Suites for Intensive Therapy
Intensity-Modulated Radiation Therapy
Outpatient Outlier Payments for Short-Stay Claims
Comparison of Provider-Based and Freestanding Clinics
Reconciliation of Outlier Payments
Hospital Use of Outpatient Stays Under Medicare’s Two Midnight Rule
Case Review of Inpatient Rehabilitation Hospital Patients Not Suited for Intensive Therapy
Medicare Costs Associated with Defective Medical Device
Payment Credits for Replaced Medical Device That Were Implanted
Medicare Payment for Overlapping Part A Inpatient Claims and Part B Outpatient Claims
Selected Inpatient and Outpatient Billing Requirements
Duplicate Graduate Medical Education Payments
Indirect Medical Education Payments
Outpatient Dental Claims
Nationwide Review of Cardiac Catheterization and Endomyocardial Biopsies
Payments for Patients Diagnosed with Kwahiorkor
Use if Hospital Wage Data Used to Calculate Medicare Payments
CMS Validation of Hospital-Submitted Quality Reporting Data
Long Term Care Hospitals – Adverse Events in Post-acute-Care for Medicare Beneficiaries
Hospital Preparedness and Response to Emerging Infectious Diseases
Nursing Home Complaint Investigation Data Brief
Skilled Nursing Facilities – Unreported Incidents of Potential Abuse and Neglect
Skilled Nursing Facility Reimbursement
Skilled Nursing Facility Adverse Even Screening Tool
National Background Checks for Long Term Care Employees – Mandatory Review
Skilled Nursing Facility Prospective Payment System Requirements
Potentially Avoidable Hospitalizations of Medicare and Medicaid Eligible Nursing Facility Residents
Medicare Hospice Vulnerabilities and Recommendations for Improvement
Review of Hospices Compliance with Medicare Requirements
Hospice Home Care – Frequency of Nurse On-Site Visits to Assess Quality of Care and Services
Comparing HHS Survey Documents to Medicare Claims Data
Home Health Compliance with Medicare Requirements
Part B Services During Non Part-A Nursing Home Stays; Durable Medical Equipment
Medicare Market Share of Mail-Order Diabetics Testing Strips
Positive Airway Pressure Device Supplier – Supplier Compliance Documentation Requirements for Frequency and Medical Necessity
Orthotic Braces – Reasonableness of Medicare payments Compared to Amount Paid by Other Payors
Osteogenesis Simulators – Lump Sum Purchase Versus Rental
Power Mobility Devices – Lump Sum Purchase Versus Rental
Competitive Machines and Related Drugs – Supplier Compliance with Payment Requirements
Access to Durable Medical Equipment in Competitive Bidding Areas
Orthotic Braces – Supplier Compliance with Payment Requirements
Nebulizer Machines and Related Drugs – Supplier Compliance with Payment Requirements
Access to Durable Medical Equipment in Competitive Bidding Areas
Monitoring Medicare Payments for Clinical Diagnostic Laboratory Tests – Mandatory Review
Medicare Payments for Transitional Care Management
Medicare Payments for Chronic Care Management
Data Brief on Financial Interests Reported Under the Open Payments Program
