Post Date: November 29, 2016

Each year the U.S. Department of Health and Human Services (HHS), Office of the Inspector General (OIG) releases a Work Plan for the upcoming fiscal year.1 The Work Plan summarizes new and ongoing reviews and activities that the OIG plans to pursue with respect to HHS programs and operations during the current fiscal year and beyond. Some of the projects described in the Work Plan are statutorily required and others relate to risk areas identified by the OIG.

Earlier this month, the OIG released its Work Plan for FY2017. It includes reviews and activities related to HRSA, delivery system reform in both Medicaid and Medicare, and other financial reviews. Activities include:

Health centers:

  • Review health center compliance with Affordable Care Act grant requirements (on-going)
  • Review HRSA’s oversight of vulnerable health center grantees (on-going)
  • Review state compliance with Maternal, Infant and Early Childhood Home Visiting (MIECHV) funding requirements (on-going)
  • Review a tribally operated FQHC (funded by IHS) to determine whether health services meet applicable federal requirements (new)

Medicaid delivery system reform:

  • Review state incentive payments to providers (new)
  • Review accountable care models (medical homes and ACOs) for compliance (new)
  • Determine whether CMS recouped and reported overpayment collections (new)
  • Review states’ assignment of Medicaid-only providers to the federally-designated risk categories (new)
  • Review states’ use of provider payment suspensions during pending investigations of credible fraud allegations (on-going)

Medicare delivery system reform:

  • Review beneficiary assignment and shared savings payments (on-going)

Financial reviews:

  • Review quality of audits conducted by non-federal auditors, such as public accounting firms and state auditors, in accordance with the Uniform Grant Guidance (on-going)

For more on the OIG’s FY2017 Work Plan, join us for our upcoming webinar, “OIG Year in Review.”

1. Available at https://oig.hhs.gov/reports-and-publications/workplan/.