The following is the 2017 OIG Work Plan overview. This is a high level look at the various items and areas that the Department of Health and Human Services (HHS) Office of the Inspector General (OIG) have laid out as areas of focus for fiscal year 2017.
2017 OIG Work Plan overview-areas of new and ongoing reviews and activities
The following 2017 OIG Work Plan overview summarizes the reviews and activities of this year’s document by major category and provider type. You will note that it is further broken down by “new”and “reviewed” reviews and activities. “New” refers to those items that have been initiated since the April, 2016 mid-year update. “Reviewed” refers to those items that have been classified as “Revised” by the OIG and reflects those items that have substantially changed since the April, 2016 mid-year update. In addition, the “Reviewed” column includes those items that have been included in prior work plans/updates.
| ITEM REVIEWED | # REVIEWED | # NEW |
| CMS: Medicare Part A and B | ||
| Hospitals | 18 | 4 |
| Nursing Homes | 3 | 4 |
| Hospices | 0 | 3 |
| Home Health Services | 1 | 1 |
| Medical Equipment and Supplies | 7 | 3 |
| Other Providers and Suppliers | 16 | 5 |
| Prescription Drugs | 2 | 2 |
| Part A and Part B Contractors | 5 | 0 |
| Other Part A and B Program Management Issues: Delivery System Reform | 3 | 0 |
| Other Part A and B Program Management Issues: Billing and Payments | 1 | 2 |
| Medicare Parts C and D | ||
| Part C – Medicare Advantage | 2 | 2 |
| Part D – Prescription Drug Program | 8 | 3 |
| Medicaid Program | ||
| Medicaid Prescription Drug Reviews | 8 | 1 |
| Home Health Services and Other Community-Based Care | 3 | 1 |
| Other Medicaid Services, Equipment and Supplies | 3 | 0 |
| State Claims for Federal Reimbursement | 5 | 0 |
| Delivery System Reform | 0 | 2 |
| State Management of Medicaid | 8 | 4 |
| OIG Oversight and Reviews of State Medicaid Fraud Control Units | 2 | 0 |
| Medicaid Information System Controls and Security | 4 | 0 |
| Medicaid Managed Care | 6 | 1 |
| Health Insurance Marketplaces | ||
| Payments | 4 | 0 |
| Eligibility | 2 | 0 |
| Management and Administration | 1 | 1 |
| Electronic Health Records | ||
| Electronic Health Records | 2 | 0 |
| CMS-Related Legal and Investigative Activities | ||
| Legal Activities | 0 | 0 |
| Exclusions from Program Participation | 0 | 0 |
| Civil Monetary Penalties | 0 | 0 |
| False Claim Act Cases and Corporate Integrity Agreements | 0 | 0 |
| Providers’ Compliance and Corporate Integrity Agreements | 0 | 0 |
| Advisory Opinions and Other Industry Guidance | 0 | 0 |
| Provider Self Disclosure | 0 | 0 |
| Investigative Activities | 0 | 0 |
| Healthcare Fraud Strike Force Teams and Other Collaborative Efforts | 0 | 0 |
| Public Health Reviews | ||
| Center for Disease Control and Prevention | 5 | 0 |
| Food and Drug Administration | 7 | 1 |
| Health Resources and Services Administration | 3 | 0 |
| Indian Health Service | 3 | 2 |
| National Institutes of Health | 4 | 1 |
| Substance Abuse and Mental Health Services Administration | 1 | 0 |
| Other Public Health-Related Reviews | 4 | 0 |
| Public Health Legal Activities | 1 | 0 |
| Human Services Reviews | ||
| Administration for Children and Families | 7 | 1 |
| Administration for Community Living | 1 | 0 |
| Other HHS-Related Reviews | ||
| Financial Statement Audits and Related Reviews | 2 | 0 |
| Financial Reviews | 5 | 2 |
| Information Security | 2 | 1 |
| Other HHS-Related Issues | 0 | 1 |