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 July’s OIG Work Plan are the following:

  1. Identification of HHS Cybersecurity Vulnerabilities
  2. Increased Payments for Transfer Claims with Outliers
  3. HRSA’s Oversight of Funds for Access Increases in Mental Health and Substance Abuse Services (AIMS)

Find the full list of Recently Added Items on OIG’s site. Did you miss a monthly OIG Work Plan update? Find all of this year’s releases by clicking here.

July’s agenda includes nine new items from OIG. Let’s walk through some of these updates so you can address each item within your compliance program, if applicable.

Identification of HHS Cybersecurity Vulnerabilities

With the continued evolution of data and how we use it comes to some pros and cons. On the one hand, it makes our jobs easier with automation and clarification. On the flip side, safely storing so much information (some that may be personal) can present unique challenges to mitigate cybersecurity threats. The United States Department of Health and Human Services is just as concerned with their level of accountability to protect data.

HHS OIG will be auditing various possibilities of compromise in regards to OPDIV (HHS Office of the Secretary and Operating Divisions) systems and IT networks.

Read the full update from OIG here.

Increased Payments for Transfer Claims with Outliers

The Centers for Medicare and Medicaid Services (CMS) requires a transfer rule reduction for payments on a Medicare beneficiary claim when it comes to the following entities:

  • Diagnosis Related Group (DRG)
  • Disproportionate Share Hospital (DSH)
  • Indirect Medical Education (IME)

The Office of Inspector General (OIG) will be reporting on the extent to which additional Medicare outlier payments negate the reduction in DRG, DSH, and IME payments of transfer claims.

Find out more information here.

HRSA’s Oversight of Funds for Access Increases in Mental Health and Substance Abuse Services (AIMS)

The opioid epidemic continues to be a top priority for HHS and the OIG. When it comes to distributing Mental Health and Substance Abuse (AIMS) grants for increases in access, the Health Resources and Services Administration (HRSA) administered $200.5 million across 1,178 health centers across the nation in 2017.

OIG will be reviewing the controls within HRSA in determining whether they are suitable for awarding AIMS grants, as well monitoring AIMS grant recipients.

Click here to find out more about this update.


Other updates to the July 2018 OIG Work Plan include the following:

  • Review of Outpatient 3-Dimensional Conformal Radiation Therapy Planning Services
  • Review of Post-Operative Services Provided in the Global Surgery Period
  • SAMHSA’s Oversight of Accreditation Bodies for Opioid Treatment Programs

Do you have any recent experience or information concerning OIG’s Work Plan updates for July? Maybe there’s a question you are urgent to ask for more insight.

Let us know in the comments below!


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Written by Michael Rosen, ESQ

ProviderTrust Co-Founder, mrosen@providertrust.com

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.

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