CHA News Article

OIG Releases Work Plan for FFY 2015

The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) has released its work plan for federal fiscal year (FFY) 2015, summarizing new and ongoing reviews and activities that OIG plans to pursue in FFY 2015 and beyond. For FFY 2015, OIG says it will focus its efforts on investigating appropriate payments, quality of care, and providing oversight of payment and delivery reform. Notable to hospitals, OIG will investigate the impact of the two-midnight policy on hospital billing, Medicare payments and beneficiary copayments. OIG also plans to review and compare Medicare payments for physician office visits in provider-based clinics and freestanding clinics to determine the differences in payments for similar procedures. In a separate report, OIG plans to determine the extent to which provider-based facilities meet the Centers for Medicare & Medicaid Services’ (CMS) criteria, with a particular focus on financial incentives that may be presented by provider-based status.

In addition, OIG plans to study employee compensation in two separate reports. One of the reports will review data on salary amounts included in operating costs to determine the potential impact on the Medicare Trust Fund if the amount of employee compensation that could be submitted to Medicare for reimbursement was limited on future cost reports. OIG also plans to review how hospitals report deferred compensation costs in a study on how reporting of wage index data is used to calculate Medicare payments. Among its reports focusing on quality of care, OIG plans to evaluate the extent and nature of hospitals’ participation with quality improvement organizations, and adverse events in inpatient rehabilitation facilities and long-term care hospitals. The full work plan is available for download on the OIG’s website.