OIG 2016 Work Plan Focuses on Medicare Part D Sponsor Compliance

October 14th, 2016

The Office of Inspector General (OIG) has released its 80-page work plan for 2016. The work plan describes various projects that are being addressed by the Office of Audit Services, Office of Evaluation and Inspections, Office of Investigations, and Office of Counsel to the Inspector General.

This year, the work plan summarizes new and ongoing reviews, with new focus areas regarding Medicare Part D pharmacy sponsor compliance. A report is expected to be published in 2017 that will address how pharmacies determine beneficiary eligibility in the Part D program. The OIG is also looking at Part B claims for orthopedic braces to determine medical necessity. Other topics include target specialty drugs, Medicare drug utilization review, chiropractic claims, hospital claims, billing, payments, reconciliation of outlier payments, admissions, the two-midnight rule, oversight of provider-based facilities, and more.

To view a copy of the OIG’s 2016 work plan, please visit http://oig.hhs.gov/reports-and-publications/archives/workplan/2016/oig-work-plan-2016.pdf.