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HHS and OIG Release Fiscal Year 2017 Work Plan – Highlights

November 15, 2016

The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG), fiscal year 2017 Work Plan gives an overview of new initiatives and activities as well as reports on ongoing programs.

According to a HMENEWS, the recently released work plan includes the OIG’s plans to review, “the process CMS used to conduct competitive bidding and to make subsequent pricing determinations for certain medical equipment items and services in selected bid areas under Rounds 1 and 2 of the program. It will also determine the effects of the competitive bidding on Medicare beneficiaries’ access to certain types of DMEPOS subject to the program.” http://www.hmenews.com/article/brief-oig-review-bid-program-hhs-asks-court-not-intervene-medicare-appeals-process

Among the new items to be addressed in the Medicare Parts A and B category are:

• Hyperbaric Oxygen Therapy Services – Provider Reimbursement in Compliance with Federal Regulations.
• Inpatient Psychiatric Facility Outlier Payments
• Case Review of Inpatient Rehabilitation Hospital Patients Not Suited for Intensive Therapy
• Nursing Home Compliant Investigation Data Brief
• Skilled Nursing Facilities – Unreported Incidents of Potential Abuse and Neglect
• Skilled Nursing Facility Reimbursement
• Skilled Nursing Facility Adverse Event Screening Tool
• Medicare Hospice Benefit Vulnerabilities and Recommendations for Improvement, A Portfolio
• Review of Hospices Compliance with Medicare Requirements
• Hospice Home Care – Frequency of Nurse On-site Visits to assess Quality of Care and Services
• Comparing HHA Survey Documents to Medicare Claims Data
• Part B Services during Non-Part A Nursing Home Stays: Durable Medical Equipment
• Medicare Market Share of Mail-Order Diabetic Testing Strips: April 1-June 30, 2016 – Mandatory Review
Positive Airway Pressure Device Supplies – Supplier Compliance with Documentation Requirements for Frequency and Medical Necessity

Among the Revised items is National Background Checks for Long-Term-Care Employees — Mandatory Review. Following is the detail on this item as found in the report: The ACA provides grants to States, through CMS, to implement background check programs of prospective long-term-care employees and providers. The ACA requires that OIG conduct an evaluation of this grant program, known as the National Background Check Program, after its completion (ACA 6201). For States that closed their grants in the preceding year, we will review the procedures States implemented for long-term-care facilities and providers to conduct background checks on prospective employees who would have direct access to patients. We will determine the outcomes of the States’ programs and whether the checks led to any unintended consequences. — OEI: 07-16-00160 • Expected Issue Date: FY 2017

Juliette WillardWritten by Susen Sawatzki
Healthcare Industry Expert
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