The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Update & Changes to the OIG Work Plan

Update & Changes to the OIG Work Plan

February 8, 2019 • By From the College

  • Tweet
  • Email
Print-Friendly Version / Save PDF

Early last fall, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its OIG Work Plan for fiscal year 2018–2019, which is a two-year framework for the audits, inspections, evaluations and investigative activities planned in support of its vision, mission, and strategic goals and objectives to maintain HHS program integrity. The OIG continues to look at key areas that affect quality patient care and outcomes, and determined it would be more beneficial to release their projects work on an ongoing basis instead of biannual updates. The OIG considers several factors when creating Work Plan items, including legal mandates, congressional requests, budgetary concerns, as well as the potential for positive impact. The new format will include an ongoing list of active work plan items, which will comprise newly initiated Work Plan items and notifications of completed items.

You Might Also Like
  • OIG Releases 2017 Work Plan: A Summary
  • Avoid Compliance Risks When Using Billing Companies
  • Update on Meaningful Use
Explore This Issue
February 2019
Also By This Author
  • Hot Topics, Fresh Formats: ACR/ARP Annual Meeting Clinical Session Preview

Key areas of potential risk that rheumatology practices should be aware of include the following:

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Financial Impact of Health Risk Assessments & Chart Reviews on Risk Scores in Medicare Advantage
Payments to Medicare Advantage (MA) organizations are risk adjusted, based on beneficiary information, to determine which MA organizations have higher expected costs. Health risk assessments and chart reviews are an integral part of this process. The OIG seeks to determine which diagnoses solely generated by their integral process correlate with high- and low-risk scores and payments.

Identify Patients at Risk of Opioid Misuse
Because opioid abuse and overdose deaths are at crisis levels in the U.S., the OIG is analyzing data from 2013–2016 on opioid overdose trends from the Centers for Disease Control and Prevention to select multiple states for review. They will review the oversight of opioid prescribing and monitoring of opioid use in the selected states, specifically on policies and procedures, data analytics, programs, outreach, and other efforts. To support HHS’s ongoing efforts to identify and disseminate effective practices to address the opioid epidemic in the U.S., the OIG will highlight these statewide efforts throughout 2019.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Critical Care Evaluation & Management Services
For 2019, the OIG will determine whether Medicare payments for critical care are appropriate and are being paid  in accordance with Medicare requirements. Payments for chronic care management services (non-face-to-face services provided to Medicare beneficiaries who have multiple significant chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation or functional decline where the significant chronic conditions are expected to last at least 12 months or until the death of the patient) will be reviewed to verify if they were in accordance with Medicare requirements.

Pages: 1 2 | Single Page

Filed Under: From the College, Practice Management Tagged With: evaluation and management (E/M), HHS program, Medicare Advantage, Medicare payments, Office of Inspector General (OIG), OIG Work Plan, Opioid misuseIssue: February 2019

You Might Also Like:
  • OIG Releases 2017 Work Plan: A Summary
  • Avoid Compliance Risks When Using Billing Companies
  • Update on Meaningful Use
  • How Rheumatologists Can Plan for Extended Work Absences

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2022 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.