Continuous updates are made to the OIG work plan to anticipate and respond to the various issues throughout the year. Earlier, these updates were done once or twice in a year. But today in this changing era of healthcare and most importantly, to increase transparency, OIG now updates its website monthly. The work plan of the OIG mostly includes OIG audits and evaluation, issues that outcross departmental programs, newly initiated work plan items and recently published reports.
For the current year 2019, OIG has several new items to its work plan. Some of them are:
NIH (The National Institutes of Health) and Peer Reviewers: Initial Vetting and Ongoing Oversight
Inappropriately sharing important and confidential information in grant applications causes risk to intellectual property and sabotage the integrity of peer review. Therefore, to examine the effectiveness of NIH’s efforts to protect the intellectual property, OIG added this to its work plan.
Medicare Part B Payments for Podiatry and Ancillary Services
Medical Part B covers podiatry services that include medical conditions related to the foot, ankle or lower leg. It does not cover routine services until and unless they are performed as an integral part of covered services. Some ancillary services are also included such as x-rays, laboratory tests, physical therapy, and durable medical equipment or prescribed drugs. These services were added to check whether they were medically necessary or in accordance with Medicare requirements.
NIH’s Implementation of Financial Conflict of Interest regulations
NIH awards grants to both domestic and foreign researchers that comprises of more than 3/4th of the NIH’s Billion budget. The motive of adding this to work plan is to check or ensure that whether policies, procedures, and controls of NIH ensure that both domestic and foreign grantees disclose all sources of analysis support, monetary interests, and affiliations.
Nursing Facility Staffing: Reported Levels and CMS oversight
The nursing facility plays an important role in improving care coordination. Why these facilities are added to the OIG work plan? This is because it will provide two reports. One would be regarding nursing staffing levels and the second one would be regarding CMS’s efforts to ensure data accuracy and improved quality of care.
Characteristics of Part D Beneficiaries at Service Risk of Opioid Misuse or Overdose
More than 40,000 deaths were reported due to misuse or overdose in the USA. OIG realized that there is a great need to have a deeper knowledge regarding the case. The study involves:
- The characteristics of these beneficiaries, including their demographics and diagnoses
- The opioid utilization of these beneficiaries and
- The extent to which these beneficiaries have had adverse health effects related to opioids and any overdose incidents.
To get more information about OIG work plan for the fiscal year 2019, join us on our upcoming live webinar “OIG: Trends, Reports, and Issues: FY2019” which will be live on “03/28/2019”.