The Office of Inspector General (OIG) Work Plan for 2009 (Effective September 2008) describes activities that the OIG plans to initiate or continue with the respect to the programs and operations of the Department of Health and Human Services (HHS).

The OIG carries out its mission of protecting HHS program integrity and beneficiary well-being by detecting and preventing waste, fraud and abuse by holding accountable those who violate program requirements. The OIG conducts audits, investigations and inspections and can and will impose monetary penalties and administrative sanctions. Over the last several years, the OIG has allocated 80% of its resources to reviews and investigations of the Medicare and Medicaid programs.

The OIG conducts a work-planning process to identify the areas of focus for the upcoming year.
Medicare Part B Related Reviews of interest for 2009:

• Place of Service Errors – Determine whether physicians properly coded the places of service on claims provided in ASCs and hospital outpatient departments.
• E&M Services During Global Surgery Periods - Determine whether industry practices related to the number of E&M services provided during the global surgery period have changed since the global surgery fee concept was developed in 1992.
• Medicare Payments for Colonoscopy Services – Determine whether payments for services were properly supported, billed and paid in accordance the Medicare requirements.
• Physicians’ Medicare Services Performed by Non-physicians – Examine the qualifications of non-physician staff that perform “incident to” services and assess whether these qualifications are consistent with professionally recognized standards of care.

The entire Work Plan is available online if you wish to view/print the information