The January 2026 OIG Work Plan updates introduce six new focus areas signaling where audits, enforcement, and compliance risk are headed next.
The January 2026 updates to the OIG Work Plan kick off the year with six new items that expand oversight across Medicare Advantage, Medicaid, Medicare Part D, federal contracting, research funding, and emergency health programs.
These updates provide early insight into where the Centers for Medicare & Medicaid Services, states, plan sponsors, and providers may face increased scrutiny in the months ahead.
New OIG Focus Areas Include:
- HCC Risk Adjustment Models: Review of diagnosis codes submitted under the Medicare Advantage V28 model and whether projected savings were achieved.
- HHS Terminated Contracts: Evaluation of whether contract terminations and de-obligations followed federal acquisition requirements.
- NIH Autism Research Awards: Oversight of Other Transaction awards issued under the NIH Autism Data Science Initiative.
- Medicaid Unenrolled Providers: Examination of improper payments tied to providers not enrolled in Medicaid FFS or managed care programs.
- Indian Health Service Emergency Funds: Review of how the Catastrophic Health Emergency Fund is administered and reimbursed.
- Medicare Part D Fraud: Assessment of whether bad-actor pharmacies continue to bill and receive Part D payments.
This update highlights where documentation, enrollment, payment integrity, and fraud prevention processes may be tested—and how organizations can proactively prepare.