Department of Health and Human Services – Office of Inspector General
Physicians and practices should be aware of the federal compliance initiatives that impact healthcare reimbursement and management of patient care. The Office of Inspector General (OIG) leads these compliance initiatives and provides a detailed monthly work plan that helps provide transparency to these ongoing efforts.
- The OIG’s mission is to protect the integrity of Department of Health & Human Services (HHS) programs as well as the health and welfare of program beneficiaries.
- A majority of the OIG’s resources goes toward the oversight of Medicare and Medicaid programs that represent a significant part of the Federal budget and that affect this country’s most vulnerable citizens.
- The OIG has developed a series of voluntary compliance program guidance documents directed at various segments of the health care industry, such as hospitals, nursing homes, third-party billers, and durable medical equipment suppliers, to encourage the development and use of internal controls to monitor adherence to applicable statutes, regulations, and program requirements.
In an effort to help physicians and practices stay in compliance at a federal and state level NEPHO will be providing up to date information monthly on the active work plan items the OIG is working on.
OIG Work Plan Goals
- Promote Positive Change within the Medicare & Medicaid Healthcare System
- Foster Increased Accountability and Integrity at a Federal and State Level
- Address Core Challenges to help Improve Healthcare Operations
- Fight Fraud, Waste and Abuse
- Provide Transparency on Federal and State Compliance Program Initiatives
OIG Work Plan Items February 2019
- Medicare Part B Payments for Podiatry and Ancillary Services (Link)
- Characteristics of Part D Beneficiaries at Serious Risk of Opioid Misuse or Overdose (Link)
- Ensuring Dual-Eligible Beneficiaries’ Access to Drugs Under Part D: Mandatory Review (Link)