The OIG is Ready to Take Down Non-compliance.

The OIG is ready to take down non-compliance and they’ve added a few new items to their work plan. The OIG plans to target Medicaid claims for ABA services provided to children diagnosed with autism to see if the Medicaid payments are legit. They’re going after ABA (Applied Behavioral Analysis–A common treatment for Autism) providers for unallowable payments made for unacceptable services.

The OIG is also targeting improper POS coding. Place-of-Service (POS) codes can significantly impact the amount of reimbursement Medicare will make to providers, and they suspect that Medicaid might be overpaying. We all know that the OIG is serious about overpayments.

What else can we find in the OIG’s most recent work plan update? They’re turning a watchful eye towards international grants. The OIG has previously identified NIH's oversight of grants to foreign applicants as a potential risk to meeting program goals and the appropriate use of Federal funds.

Last but certainly not least, the OIG will be looking into ways to optimize the procedures for the clinical diagnostic laboratory test rate-setting for public health emergencies. Think, Covid. While they might have taken a momentary pause to look into Covid-related compliance issues, they’re at it now with a vengeance, and they’ve got their master auditing power locked and loaded.

Get the full scoop and find out if your organization might be impacted by the new work plan items as the OIG investigates the:

• Legitimacy of Medicaid Payments for ABA Services
• Accuracy of POS Codes
• Ideal Procedure for Clinical Diagnostic Laboratory Test Rate-Setting for Future Public Health Emergencies
• NIH's Monitoring of Selected Grants, Grantee Use and Management of NIH Grant Funds