HMS recently blogged about the 2015 Office of Inspector General (OIG) Work Plan. The 2015 Work Plan covers a broad range of topics related to CMS programs, organized by provider type. Here are some highlights from the home health services section:
The OIG will review compliance and various aspects of the home health prospective payment system (HHPPS), including the documentation required in support of the claims paid by Medicare. The OIG will determine if claims were paid in accordance with federal laws and regulations. The OIG notes that that a pior report found that one in four home health agencies had questionable billing. Due to their record of fraud, waste, and abuse, the OIG has designated newly enrolled home health agencies as high-risk providers.
The OIG will also examine records of home health agencies that employ individuals with criminal convictions. Most states have laws prohibiting healthcare entities, including home health agencies, from employing certain individuals with certain types of criminal convictions.
Click here to see the plan.