OIG February 2019 Work Plan Update

PUBLISHED: Feb 20, 2019
Relevant to: All Healthcare Organizations

The Office of the Inspector General (OIG) recently released updates to their Work Plan. As StayAlert! has previously reported, in 2017 OIG transitioned from a yearly to a monthly update. OIG hopes that a monthly update will enhance transparency around OIG's continuous work planning efforts.

For February 2019, the following selection of OIG Work Plan activities are of interest to healthcare organizations:

Medicare Part B Payments for Podiatry and Ancillary Services

Prior OIG work identified inappropriate payments for podiatry and ancillary services. OIG will review Part B payments to determine whether podiatry and ancillary services were medically necessary and supported in accordance with Medicare requirements.

NIH's Implementation of Financial Conflict of Interest Regulations

This review will determine whether The National Institutes of Health (NIH) has policies, procedures, and controls in place for ensuring that both foreign and domestic grantees disclose all sources of research support, financial interests, and affiliations.

Nursing Facility Staffing: Reported Levels and CMS Oversight

Staffing levels in nursing facilities can impact residents' quality of care. Nursing facilities that receive Medicaid and Medicare payments must provide sufficient licensed nursing services 24 hours a day, including a registered nurse for at least 8 consecutive hours every day. CMS uses auditable daily staffing data, called the Payroll-Based Journal, to analyze staffing patterns and populate the staffing component of the Nursing Home Compare website. The first of two OIG reports will be a data brief that describes nursing staffing levels reported by facilities to the Payroll-Based Journal. The second report will examine CMS's efforts to ensure data accuracy and improve resident quality of care.

Characteristics of Part D Beneficiaries at Serious Risk of Opioid Misuse or Overdose

This study will provide needed information about: (1) the characteristics of Medicare beneficiaries at serious risk of opioid misuse or overdose, including their demographics and diagnoses; (2) the opioid utilization of these beneficiaries; and (3) the extent to which these beneficiaries have had adverse health effects related to opioids and any overdose incidents.

The OIG Work Plan is a great tool for compliance departments because it provides insight into areas where government enforcement and audit officials are focusing. For more information follow the link below. Included with today’s StayAlert! Notice is an example policy related to reporting Long Term Care staffing levels.

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