The 2017 OIG Work Plan was issued by the Office of Inspector General on November 15, 2016. Historically, we have seen the Medicare Part A & B Work Plan focus primarily on hospitals with a few items for skilled nursing, home health, and hospice. This fiscal year, a total of 24 new items were added, with five focused on nursing/skilled nursing facilities and three focused on hospice or hospice home health. The remaining 16 items are a mix of outpatient services, durable medical equipment, care management/quality of care, and inpatient rehabilitation.

The Medicare Part C & D Work Plan includes a focus on payments for service dates after a date of death, denials by Medicare Advantage Plans, Part D rebates on drugs dispensed by 340B Pharmacies, and questionable billing for compounded topical drugs.

In the Medicaid arena, the OIG focus impacting providers will be on personal care services.

The following is a list of the OIG focus for each of the new topics, and items you, as a provider or supplier, may want to consider.

The summary above includes only those items new to the Work Plan this fiscal year. In addition, the OIG has revised 12 previously existing projects, and continues to carry forward other items from prior work plans that have on-going activity. Providers should continue to review and assess work plan areas for applicability to their operations.

If you have any questions, contact:

Adam Shewmaker: ashewmaker@ddafhealthcare.com
Shawn Stevison: sstevison@ddafhealthcare.com