revenue cycle

Updates to the OIG Work Plan: July 2018 Highlights

Back in June 2017, the Office of the Inspector General (OIG) announced they would begin posting monthly updates to their work plan. Keeping tabs on the OIG Work Plan is a best practice for compliance and revenue cycle professionals. The items may at times appear esoteric, but the appearance of a new initiative is akin to the proverbial canary in a coal mine.

The additions posted in July 2018 include:

  • New review of CMS payment policy in respect to 3-D radiation therapy planning services. Medicare policy prohibits payments for separately billed radiation planning services when the services are billed on a different date of service. The review by the OIG is designed to determine if the prohibition had been extended to 3-D radiation therapy.
  • The HHS OIG will perform a series of audits to assess cybersecurity vulnerabilities at HHS.
  • OIG assess the effectiveness of the Health Resources and Services Administration (HRSA) oversight of the Access Increases in Mental Health and Substance Abuse Services (AIMS) grants.
  • OIG working on a report discussing the describing the impact  of additional Medicare outlier payments in balancing the reduction in DRG, DSH, and IME payments of transfer claims. This is one for hospital revenue cycle compliance folks to watch!
  • Another CMS focused audit by the OIG was added in respect to post-operative services provided in the global surgery payment period and whether global surgery fees reflected the actual number of post-operative services provided.
  • The final item added in July is a series of audits of the Substance Abuse and Mental Health Services Administration's process and oversight in respect to SAMHSA-approved accrediting bodies that have accredited Opioid Treatment Programs (OTP).