OIG Work Plan Updates For January 2022

The OIG added many items to their Work Plan for January, including COVID-19 relief funding, hospice eligibility, identifying patient neglect or abuse, and cost report oversight. We’re here to give you the full scoop on the things that may affect your organization or compliance program.

Remember the CARES Act, Paycheck Protection, and other laws passed in response to COVID-19? These laws appropriate over $178 billion in relief funds to hospitals and other providers. But there were requirements to be met, so now the government will be looking for “surprise billing.”

The OIG identified 34,664 Medicare claims containing diagnosis codes that indicated patients were treated for injuries possibly caused by abuse or neglect from past audits. The OIG will be conducting a follow-up audit to determine whether CMS improved its use of Medicare data to identify potential abuse and neglect incidents since the OIG issued its prior report.

Hospitals’ Medicare cost reports are supposed to be audited and settled by their respective Medicare administrative contractor (MAC). The OIG wants to review whether MACs are appropriately overseeing cost report activity. They will check the MACs cost report oversight by verifying the number of desk reviews and the number of audits performed per the CMS contract and identify non-compliance issues. They’ll be doing a lot more, too.

To learn more about the OIG’s most recent Work Plan items and how you can prevent non-compliance in your organization, download this free eBrief, “OIG Work Plan Updates: COVID-19 Relief Funding, Hospice Eligibility, and More,” to get the full scoop on these items:

• COVID-19 Relief Funding
• Hospice Eligibility
• Patient Neglect or Abuse
• And More!