Each month, we are pleased to share the most recent additions to the Office of Inspector General (OIG) Work Plan items. Starting in June 2017 – OIG has been updating their Work Plan monthly with any new changes to the active list. Let’s take a look at the new points from this month.
A few topics that stood out to us for March’s OIG Work Plan are the following:
- Medicaid Nursing Home Supplemental Payments
- CMS Medicare Overpayment Recoveries Related to Recommendations in OIG Audit Reports
- Review of Refugee Cash and Medical Assistance Payments
This month’s agenda includes 6 new items from OIG. Let’s walk through some of these updates so you can address each item within your compliance program, if applicable.
Medicaid Nursing Home Supplemental Payments
In some states, CMS has approved supplemental payment for nursing home services when it comes to Medicaid. Further, some of these states are funded via local government with intergovernmental transfers.
Previous audits from the Office of Inspector General and Government Accountability Office have revealed that nursing homes may be losing out on this deal. In fact, one could say that local and state governments are benefitting the most. The OIG will be further reviewing and determining how funds are being used.
Read the full update from OIG here.
CMS Medicare Overpayment Recoveries Related to Recommendations in OIG Audit Reports
Every 6 months, the Department of Health and Human Services is responsible for resolving recommendations from federal audit reports concerning activities, grantees, and contractors. During the time period from October 2014 to December 2016, OIG issued audit reports for monetary recommendations (193) totaling $648 million in regards to Medicare.
The Centers for Medicare and Medicaid Services agreed to collect $566 million applicable to recommendations concerning overpayment recoveries. The OIG will be determining the extent to which CMS correctly handled overpayment recommendations.
To find out more about how OIG is addressing this process, visit here.
Review of Refugee Cash and Medical Assistance Payments
In adherence to The Refugee Act of 1980, the Refugee Resettlement Program (RRP) was created to help support refugees in the United States resettle and become economically self-sufficient as quickly as possible.
In regards to this program, federal Refugee Cash Assistance (RCA) and Refugee Medical Assistance (RMA) grants are given to states for cash and medical services for the refugee population. In these cases, OIG will be determining whether RCA/RMA payments to beneficiaries made by the state agency or a replacement designee, as applicable, were allowable in accordance with federal guidelines.
Read more on this review here.
Other updates to the April 2018 OIG Work Plan include the following:
- Ensuring Dual-Eligible Beneficiaries’ Access to Drugs Under Part D: Mandatory Review
- Review of Sole Incumbent Grantees’ Compliance With Head Start Program Requirements
- HHS Email Policies and Practices
Do you have any recent experience or background information concerning OIG’s Work Plan updates for April? Let us know in the comments below!
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Written by Michael Rosen, ESQ
Michael brings over 20 years of experience founding and leading risk mitigation businesses, receiving numerous accolades such as Inc Magazine’s Inc 500 Award and Nashville Chamber of Commerce Small Business of the Year.