2016 OIG Work Plan (Part 4): New Items, Continued

The OIG’s annual Work Plan is an important asset for optimizing your organization’s compliance and auditing efforts because it allows you to identify possible compliance risks. In reviewing the 2016 OIG Work Plan, there are a total of 25 projects for audit under the OIG audit umbrella: three new projects, one revised, and all of the ongoing projects that remain.

In Part 1 of this four part series I addressed the revised item, in Part 2 and Part 3, I covered new items, and in this post, Part 4, I will continue to cover new items from the 2016 OIG Work Plan.

Hospital-Related Policies and Payments: New Item

In this post we’ll be talking about CMS validated hospitals, inpatient quality reporting data, value-based purchasing program and the hospital acquired condition reduction program. The OIG Work Plan for FY 2016 has listed the item as: 

• OIG will determine the extent to which CMS validated hospital inpatient quality reporting data.
• CMS uses these quality data for the hospital value-based purchasing program and the hospital acquired condition reduction program. Therefore their accuracy and completeness are important.

We might expect to see the following from the OIG as a result:

• Report addressing how CMS met requirements validating the hospital-submitted quality data.
• Measures scoring accuracy of the data.
• Details of how CMS is taking actions as a result of the data validation.
• Additional steps CMS should take to improve data validation.

For the Accountable Care Organizations (ACOs), the OIG will be reviewing the performance of ACOs in the first three years of the Medicare Shared Savings Program (MSSP) and researching best practices of high-performing ACOs.  The OIG can then provide a report of how successful ACOs saved money while improving quality. 

For more information on this new item, watch our on-demand webinar on the "2016 OIG Work Plan for Hospitals" by clicking the button below:

• Read Part 1 . . . Part 1 of the OIG Work Plan Update Series >>
• Read Part 2 . . . Part 2 of the OIG Work Plan Update Series >>
• Read Part 3 . . . Part 3 of the OIG Work Plan Update Series >>