The HHS OIG has released its FY 2016 Work Plan, which outlines the top audit, evaluation, and other legal and investigative initiatives that the OIG intends to conduct this fiscal year. As in years past, Medicare and Medicaid oversight constitute a significant portion of the OIG's efforts. In addition to specific planned audits focusing on provider and supplier payment and quality issues, the OIG notes that future planning efforts will include additional oversight of hospice care, oversight of skilled nursing facility compliance with patient admission requirements; and evaluation of CMS's Fraud Prevention System. The OIG also highlights its intention to expand its focus on delivery system reform and the effectiveness of alternate payment models, coordinated care programs, and value-based purchasing. Many of the planned Medicaid-related reports involve drug reimbursement policies, including collection of drug rebates and specialty drug pricing. The Work Plan includes an appendix compiling planned Affordable Care Act reviews, including plans to address various risks in the areas of Marketplace management, payments/eligibility, and security of information technology and consumer information.
This article is presented for informational purposes only and is not intended to constitute legal advice.
