OIG Releases Strategic Plan 2014-2018
You may be getting anxious to get started on your physician office of hospital compliance plan for 2014. Although the 2014 OIG Work Plan release has been postponed until January 2014, the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) has thrown health compliance officers a bone with the release of OIG Strategic Plan, 2014-2018.
According to the OIG Strategic Plan, 2014-2018, the OIG’s four goals over the next four years are:
- Fight Fraud, Waste, and Abuse
- Promote Quality, Safety, and Value
- Secure the Future
- Advance Excellence and Innovation
To help OIG’s goal of fighting fraud, waste, and abuse the OIG is making the following their upcoming priorities:
Identifying, investigating, and taking action when needed – OIG will be analyzing data and conducting risk assessments of trouble areas. When criminal wrongdoing is identified and investigated, the result is “criminal convictions and penalties, civil settlements, and administrative actions against those who commit fraud.” You can find the OIG Enforcement Actions updates on their website.
OIG will also focus on Medicare and Medicaid program integrity and waste in HHS programs and will “continue implementing and refining protocols for self-disclosure of wrongdoing.” So, look for areas in your healthcare organization where waste is a concern. Target those areas with self auditing, and have a plan ready if you uncover erroneous reporting of physician services.
Holding wrongdoers accountable and maximizing recovery of public funds – Through the Health Care Fraud and Abuse Control (HCFAC) program OIG will pursue “holding fraud perpetrators accountable and to recover stolen or misspent HHS funds.” Their focus areas will include “identifying and recovering improper payments and utilizing exclusions and referrals for debarment to protect HHS programs and beneficiaries.” When making your compliance plan, you may want to include double checking the Exclusions List to be sure you aren’t employing an excluded individual(s).
Preventing and deterring fraud, waste, and abuse – To lessen HHS program vulnerability to fraud, waste, and abuse, OIG will be implementing safeguards, such as strengthening program administration and grants management. They are educating healthcare providers and supplying fraud and abuse prevention tools on their website using Compliance Education Material. This is a great resource for training and educating providers and healthcare boards on compliance.