OIG Work Plan 2016: Top Things to Watch

OIG Work Plan 2016: Top Things to Watch 

 OIG’s Strategic Plan outlines the vision and priorities that guide OIG in carrying out its mission to protect the integrity of HHS programs and operations and the health and welfare of the people they serve. The Strategic Plan articulates four goals that drive OIG’s work:  

• fight fraud, waste, and abuse;

• promote quality, safety, and value;

• secure the future; and

• advance excellence and innovation.

OIG ensures an efficient and effective use of its resources through integrated planning, monitoring, and reporting processes. Together these processes are used to set organizational priorities that best further our strategic goals, measure and analyze the impact of our work, and inform strategic and operational change.

 

Clinical laboratory payments:

In 2016, the OIG plans to conduct an annual analysis of Medicare clinical diagnostic laboratory tests to examine expenditures and the new payment system.

Using EHR to support care coordination through ACO:

In 2016, the OIG will review the extent that providers participating in ACOs in the Medicare Shared Savings Program use electronic health records to exchange health information to achieve their care coordination goals.

Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) requirements:

The OIG will review the compliance of the IRF PPS in 2016, which covers the documentation required in support of the claims paid by Medicare.

Intensity-modulated radiation therapy (IMRT) Services:

In past OIG review have identified hospitals that have incorrectly billed for IMRT services. Hospitals need to be aware that the OIG intends to review Medicare outpatient payments for IMRT beginning in 2016.

Effects of the Competitive Bidding Program on Medicare Beneficiaries Access to durable medical equipment:

The OIG have plans of determining the effects of the competitive bidding program on Medicare beneficiaries’ access to certain types of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)—in 2016.

 

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