The HHS OIG’s latest Work Plan updates provide important insight into the billing practices, operational risks, and compliance areas likely to face increased scrutiny moving forward.
The HHS OIG’s latest Work Plan updates highlight several areas that could face increased audits, investigations, and enforcement attention moving forward.
From Medicare refund requirements and payment oversight to Medicaid eligibility controls and Medicare Advantage prior authorization practices, the newly added focus areas point to growing concerns around program integrity and compliance risk.
Some of the key areas drawing attention include:
- Medicare deductible and coinsurance refund requirements
- Medicare payments for Spravato
- Medicaid payments tied to terminated providers
- Children missing from foster care programs
Historically, OIG Work Plan additions often signal where future scrutiny may increase. That makes this an important opportunity for organizations to proactively evaluate risk areas, strengthen oversight processes, and identify vulnerabilities before external reviews begin.