Industry News

OIG Releases Fiscal Year 2016 Work Plan.

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently released its Work Plan for fiscal year (FY) 2016. The OIG protects the integrity of HHS programs by preventing fraud, waste, and abuse and by identifying opportunities to improve program effectiveness and efficiency. The FY 2016 Work Plan outlines new and continuing OIG reviews of HHS programs and operations. For each planned review, the OIG Work Plan provides an internal identification code and the year in which the OIG expects to issue results. The OIG will review entities such as hospitals, nursing homes, and home health services.

Examples of OIG Work Plan items for FY 2016 include:

  • Medical device credits for replaced medical devices;
  • Medicare payments during Medicare Severity Diagnosis Related Group payment window;
  • Center for Medicare & Medicaid Services (CMS) validation of hospital-submitted quality reporting data;
  • Skilled nursing facility prospective payment system requirements;
  • Medicare Part B payments for drugs purchased under the 340B program;
  • Covered uses for Medicare Part B drugs;
  • Accountable care organization quality and cost performance and strategies;
  • CMS management of the implementation of the tenth revision of the International Classification of Diseases;
  • Review of financial interests reported under the Open Payments Program; and
  • CMS oversight of state Medicaid information systems security controls.

Providers should examine the OIG Work Plan and review risk areas that may instigate OIG enforcement actions.

The 2016 OIG Work Plan is available at:

http://oig.hhs.gov/reports-and-publications/archives/workplan/2016/oig-work-plan-2016.pdf.

Department of Health and Human Services Office of Inspector General. “Work Plan for Fiscal Year 2016.” Work Plan. 2 Nov. 2015.