OIG Reports on Modifications to its Annual Work Plan.

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently reported on modifications to their annual Work Plan.  As of June 15, 2017, the OIG will update its annual Work Plan website on a monthly basis, in an effort to increase transparency around its work planning efforts.  The web-based Work Plan will incorporate monthly updates that identify new Work Plan items and remove the completed projects.  Since the November publication of the 2017 OIG Work Plan, for example, the OIG has added several new projects to the Work Plan.  These additional items are now listed on the Work Plan website.

The OIG Work Plan outlines ongoing and planned OIG audits and evaluations for the fiscal year and beyond.  As part of the work planning process, the OIG determines which areas require the most attention by assessing relative risks in HHS programs and operations.   The OIG chooses among Work Plan projects by considering several factors, including: 1) legal, regulatory or other directives mandating OIG review; 2) Congressional, HHS or other federal agency requests; 3) top HHS management and performance challenges; 4) other oversight organization project plans; 5) past management actions to implement previous OIG recommendations; and 6) potential for positive impact.  Alongside their audit, review and reporting projects, the OIG also engages in some separately reported legal and investigative activities.

Recent additions to the 2017 OIG Work Plan include the following:

1. Review of Quality Measures Data reported by Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program (MSSP).

• The OIG will review whether MSSP ACOs reported quality measures data in compliance with federal requirements.

2. Data Brief Exploring Excessive Use of Opioids in Medicare Part D.

• The OIG Data Brief will analyze opioid utilization among Medicare Part D beneficiaries and provide baseline data regarding doctor shopping and the receipt of extreme opioid amounts. The report will also identify prescribers with suspicious opioid prescribing patterns.  The OIG will build upon its previous work highlighting increased Part D spending for commonly abused opioids and the drug diversion problem.

3. Examination of Access to Buprenorphine-Waivered Providers for Medication-Assisted Treatment (MAT) of Opioid Use Disorder.

• The OIG will examine different facets of access to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) buprenorphine waiver program. The waiver program allows providers to prescribe buprenorphine in their office setting, rather than in opioid treatment facilities.  The examination of access will involve reviewing: 1) the number, location and patient capacity of program providers; 2) the availability of providers in areas with the greatest need for MAT services; 3) the number of reported patients being treated with buprenorphine; and 4) the factors that may facilitate or hinder buprenorphine provision in the office setting.

4. Review of CMS’ Inclusion of Non-Covered Versions when Setting Payment Amounts for Part B Drugs.

• The OIG will review the methodology for calculating some Part B drug payment amounts using the price of Non-Covered, self-administered versions of the drug. The review will also examine the resulting cost impact on Medicare and its beneficiaries.

5. Follow-up Evaluation of CMS’ Management of the Quality Payment Program.

• The OIG will evaluate CMS’ progress in addressing the key implementation challenges to the value-based Quality Payment Program (QPP). The OIG will review CMS’ efforts relating to clinician outreach, training efforts and the development status of the backend IT system required for the program.

6. Trends in Hospice Deficiencies and Complaints.

• The OIG will assess the nature and extent of hospice deficiencies in meeting federal health and safety standards cited by accredited national organizations and state survey agencies. The review will also examine complaints and identify deficiency trends.  In previous reports, the OIG has identified vulnerabilities and highlighted concerns about limited enforcement actions against under-performing hospices.

The OIG web-based Work Plan and additional 2017 Work Plan new project listings are available at:

https://oig.hhs.gov/reports-and-publications/workplan/.