OIG Lists Top Management and Performance Challenges

The Office of Inspector General (OIG) identified, Jan. 6, the most significant management and performance challenges facing the U.S. Department of Health and Human Services (HHS) this year. The integrity of the Medicare program is No. 2 on the list.

The “hot topics” are contractor oversight, durable medical equipment (DME) fraud, and Medicare Advantage.

“OIG audits, evaluations, and investigations continue to identify improper payments,” the 2008 Executive Summary reads.

The OIG blames the lack of integrity on “an internal weakness in Medicare claims-processing controls,” which let slip through the system unallowable services, improperly-coded claims, and other improper payments, such as for wheelchairs, mental health services, imaging, and certain interventional pain-management procedures.

The OIG has also determined that Medicare’s reimbursement rate is too high for some items and services, such as Part B drugs and certain types of DME.

The full text of this report is available on the OIG Web site.

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