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What is the HHS OIG (Office of Inspector General) Work Plan?

January 26, 2021

HHS OIG Work Plan Updates

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) Work Plan includes projects set forth by the OIG Office of Audit Services and the Office of Evaluation and Inspections. The HHS OIG Work Plan includes evaluations that are currently underway or pending during the fiscal year.

Projects listed in the Work Plan span multiple departments including the Centers for Medicare & Medicaid Services (CMS), public health agencies such as the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH), and human resources agencies such as the Administration for Children and Families (ACF) and the Administration on Community Living (ACL).

OIG plans work related to issues that cut across departmental programs. The OIG also creates a plan for state and local governments’ use of federal funds and the functional areas of the Office of the Secretary of Health and Human Services.

HHS OIG Work Plan Updates from November 2020

The HHS OIG Work Plan is updated monthly to ensure that it is closely aligned with social, economic, and public health changes. As an example of this, the following projects and changes were made in November of 2020 and are listed in chronological order below:

11-02-2020

Medicare Home Health Agency Provider Compliance Audit: Visiting Nurse Association of Central Jersey Home Care and Hospice, Inc. A-02-17-01025

Updated: Corporate Integrity Agreements

11-03-2020

Updated: Corporate Integrity Agreements

11-06-2020

Cahaba Government Benefits Administrators, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-19-00575

Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-19-00576

CMS Did Not Ensure That Medicare Hospital Payments for Claims That Included Medical Device Credits Were Reduced in Accordance With Federal Regulations, Resulting in as Much as $35 Million in Overpayments A-07-19-00560

11-09-2020

Office of Refugee Resettlement Ensured That Selected Care Providers Were Prepared To Respond to the COVID-19 Pandemic A-04-20-02031

11-10-2020

Advocating for the Nation’s Elder Population: Operation CARE

Updated: Corporate Integrity Agreements

LEIE Database Updated with October 2020 Exclusions and Reinstatements

11-12-2020

Ohio Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries A-05-18-00027

Updated: Corporate Integrity Agreements

11-16-2020

Updated: Work Plan

Special Fraud Alert: Speaker Programs

In the Selected States, 67 of 100 Health Centers Did Not Use Their HRSA Access Increases in Mental Health and Substance Abuse Services Grant Funding in Accordance With Federal Requirements A-02-19-02001

Updated: Corporate Integrity Agreements

11-17-2020

2020 Top Management and Performance Challenges Facing HHS

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2020 OEI-03-21-00050

11-18-2020

Cahaba Government Benefits Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00577

Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00578

Hospitals Did Not Comply With Medicare Requirements for Reporting Cardiac Device Credits A-01-18-00502

11-19-2020

Ohio Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State A-05-19-00023

Medicare Hospital Provider Compliance Audit: Edward W. Sparrow Hospital A-05-18-00045

11-20-2020

Final Rule: Medicare and State Health Care Programs: Fraud and Abuse; Revisions to Safe Harbors under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducements

Fact Sheet: Final Rule: Revisions to the Safe Harbors Under the Anti-Kickback Statute and Civil Monetary Penalty Rules Regarding Beneficiary Inducements

Medicare Home Health Agency Provider Compliance Audit: The Palace at Home A-04-17-07067

Updated: Corporate Integrity Agreements

11-23-2020

Opioid Treatment Programs Reported Challenges Encountered During the COVID-19 Pandemic and Actions Taken To Address Them A-09-20-01001

Medicare Hospice Provider Compliance Audit: Hospice Compassus, Inc., of Payson, Arizona. A-02-16-01023

Updated: COVID-19 Fraud Alert

11-24-2020

U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Areas That Require Improvement A-17-20-54000

11-27-2020

Florida Received Unallowable Medicaid Reimbursement for School-Based Services A-04-18-07075

Why Staying Up to Date on OIG Work Plan Updates Matters

OIG Active Work Plan updates range from new information about digital and telehealth requirements to opioid treatment updates. OIG Active Work Plan updates can be searched and downloaded by keywords or dates on the OIG reports and publications website.

Staying up to date on OIG evaluations and audits is critical for hospital administration compliance. In audits, the OIG often finds over 80% of healthcare institutions out of compliance with recent updates. As a result, monetary penalties may be incurred by medical institutions and more importantly patients may not receive the needed care and/or services they require.

In order to stay up to date and remain in regulatory compliance, check the OIG Active Work Plan regularly, and be proactive in continuous screening and monitoring of your staff and medical providers. This is even more critical during rapid shifts in policy and regulation during the COVID-19 pandemic.

Juliette Willard Written by Juliette Willard
Healthcare Communications Specialist
Connect with Juliette on LinkedIn