The Office of the Inspector General of the U.S. Department of Health and Human Services has published a document presenting the areas on which it intends to focus in 2017.
Among the Medicaid issues on which the OIG will focus are delivery system reform incentive (DSRIP) payments, Medicaid ACOs, Medicaid provider taxes, Medicaid overpayments, and states’ risk assignment for providers that serve only Medicaid populations.
For Medicare, the OIG will look at many issues, including ACOs, hospital wage data, the two-midnight rule, outlier payments, a comparison of provider-based and free-standing clinics, and more.
And the OIG will examine long-term-care issues such as skilled nursing facility reimbursement, skilled nursing facilities and avoidable hospitalizations, inpatient rehabilitation facility payments, and more.
The OIG also will look at quality oversight in ambulatory surgery centers.
For a more detailed look at the OIG’s 2017 investigatory plans, go here to see its 2017 work plan.