OIG Posts 2015 Work Plan

Parts C and D of the OIG Workplan

Every year, the HHS Office of the Inspector General (OIG) publishes the workplan for the upcoming year.  This calls out the priorities and areas of focus for audit and enforcement efforts. Related to Medicare and Medicaid, the workplan highlights the particular items of concern.  This news blog is providing the workplan related to Parts C and D of Medicare, which are the Medicare Advantage and PDP areas.  

The primary categories they call out are such things as encounter data and risk adjustment for Part C, and under part D, they concentrate on the savings potential of risk corridors, annual bids documentation of costs, reconciliation of payments, access for duals to prescription drugs, potential conflicts of interest of P&T committees, documentation of PDE data and administration of the coverage gap mechanisms.  

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