OIG 2008 Work Plan - Home Health Agencies

Annually in October, the OIG releases its Work Plan for the coming Fiscal Year.  The HHS Office of Inspector General Work Plan previews OIG projects that are scheduled in the upcoming year for each of the major entities within the Department of Health and Human Services:

- Centers for Medicare and Medicaid Services

- Public Health Service Agencies

- Administrations for Children, Family, and Aging         

Information is also provided on projects related to issues that cut across departmental programs, including state and local government use of Federal funds, as well as the functional areas of the Office of the Secretary. Some of the projects described in the Work Plan are statutorily required, such as the audit of the department’s financial statements, which is mandated by the Government Management Reform Act.  The Work Plan can serve as an invaluable guide for professionals and organizations to identify the targets of OIG scrutiny and enforcement activity. The 2008 Work Plan covers the full spectrum of healthcare and human services, from medical necessity and coding issues to clinical trials and care provided in nursing homes.  Below are hot topics being targeted in the 2008 OIG Workplan:

Medicare Secondary Payer
The OIG will review Medicare payments for beneficiaries who have other insurance. Pursuant to section 1862(b) of the Social Security Act, Medicare payments for such beneficiaries are required to be secondary to certain types of insurance coverage. They will assess the effectiveness of current procedures in preventing inappropriate Medicare payments for beneficiaries with other insurance coverage. For example, they will evaluate procedures for identifying and resolving credit balance situations, which occur when payments from Medicare and other insurers exceed the providers’ charges or the allowed amount.

We again encourage management to periodically refer to the OIG Work Plan and use it as a tool to measure the Hospital's policies and procedures and determine if they are in check with the OIG’s interpretations. As a reference, we have included on our website a chart detailing all the topics addressed in the OIG Work Plans from 1997 to 2008. To view, click here.