Each month, we are pleased to share the most recent additions to the HHS 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 October’s OIG Work Plan are the following:

  1. Childcare and Development Fund: Provider Compliance with State Criminal Background Check Requirements
  2. Data Brief: Early Results from the Opioid State Targeted Response Grants 
  3. Medicaid Capitation Payments Made on Behalf of Incarcerated Individuals

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.

October’s agenda includes 4 new items from HHS OIG. Let’s walk through these updates so you can address each item within your compliance program, if applicable.

Childcare and Development Fund: Provider Compliance with State Criminal Background Check Requirements

When it comes to childcare costs for low-income families, subsidies are provided via the Child Care and Development Fund, created under the Child Care and Development Block Grant Act of 2014 (CCDBG). Childcare providers and facilities under these regulations are subject to CCDBG requirements for criminal background checks.

Thorough pre-hire employee background checks are essential to compliance and each organization’s commitment to hiring the most qualified and trustworthy individuals, so HHS OIG will be assessing compliance with these requirements established by each state.  

Read the full update from OIG here.

Data Brief: Early Results from the Opioid State Targeted Response Grants

Combatting the opioid epidemic continues to be a challenge across the United States. To help curb this large-scale problem, Opioid State Targeted Response grants ($1 billion) have been awarded and managed by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The hope of distributing these funds, according to is to SAMHSA is to “address the opioid crisis by increasing access to treatment, reducing unmet treatment need, and reducing opioid overdose-related deaths through the provision of prevention, treatment and recovery activities for opioid use disorder”. HHS OIG will be evaluating each state’s use of these opioid STR grant funds for the first year. 

Find out more information here.

Medicaid Capitation Payments Made on Behalf of Incarcerated Individuals

Capitation payments are paid out to Medicaid managed care organizations contracted by each state. In the case of inmates and receiving care, the Centers for Medicare and Medicaid Services (CMS) instructs that services are not available for those incarcerated in public institutions unless the inmate becomes an inpatient in a medical institution instead of a prison setting.

HHS OIG will be reviewing whether states made any restricted payments to Medicaid managed care organizations for individuals who were incarcerated.

To find out more information, click here.

Do you have any recent experience or information concerning OIG’s Work Plan updates for October? 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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