OIG Releases 2016 Mid-Year Work Plan

Dianne De La Mare 

The US Department of Health and Human Services (HHS), Office of Inspector General (OIG), has published its Fiscal Year WorkPlan: Mid-Year Update, 2016, setting forth the various OIG department (Office of Audit Services, Office of Evaluation and Inspections, Office of Investigations, and Office of Counsel to the Inspector General) 2016 activities.

The work plan involves projects planned in each of HHS’ major entities including, but not limited to, Centers for Medicare & Medicaid Services and Administration on Aging. The work plan also lists the 2015 HHS top management and performance challenges including:

•  protecting an expanding Medicaid program from fraud, waste and abuse;
• fighting fraud, waste and abuse in Medicare Parts A and B;
•     meaningful and secure exchange and use of electronic information and health information technology;
•   administration of grants, contracts and financial and administrative management systems;
•   ensuring appropriate use of prescription drugs;
•   ensuring quality nursing home, hospice and home- and community-based care;
•   implementing operating, and overseeing the health insurance marketplaces;
•    reforming delivery and payment in health care programs;
•    effectively operating public health and human services programs; and
•    ensuring the safety of food, drugs and medical device

New and relevant action items under CMS that have been started since Oct. 2015 include, but are not limited to:

1.       Skilled Nursing Facility Prospective Payment System Requirements;

2.        National Background Checks for Long Term Care Employees;

3.       Potentially Avoidable Hospitalizations of Medicare and Medicaid Eligible Nursing Home Residents for Urinary Tract Infections;

4.       Oversight and Effectiveness of Medicaid Waivers; and

5.       State Medicaid Fraud Control Unit FY 15 Annual Report.