December’s OIG Work Plan updates zero in on Medicaid eligibility verification, home health coding accuracy, and Medicare Part B drug pricing—signaling where compliance risk may be headed next.
The HHS Office of Inspector General doesn’t update its Work Plan lightly, and even a small number of additions can carry significant compliance implications.
In December 2025, the OIG introduced new and recurring focus areas that touch some of healthcare’s most scrutinized programs: Medicaid eligibility, Medicare home health payments, and Part B drug reimbursement. While these reviews may appear routine, they align closely with historical enforcement trends tied to documentation gaps, coding practices, and payment accuracy.
In this overview, we break down:
- Why Medicaid eligibility verification—particularly citizenship and immigration status—remains a federal priority
- What the OIG is analyzing in home health claims with comorbidity adjustments
- How ASP-to-AMP comparisons continue to shape Medicare Part B drug payment oversight
- What these focus areas mean for compliance, audit, and reimbursement teams in 2026