Well, the Office of the Inspector General (OIG) has released its FY 2015 Work Plan, not even a year after its 2014 Work Plan was released in February of 2014. The reports, generally issued in November, highlight the initiatives the agency will undertake. For nursing homes, this means additional scrutiny while the OIG reviews data, as well as the expected calls for action once they are published. Let’s take a look at what’s coming up for FY 2015.
- Medicare Part A Billing by skilled nursing facilities – This is a carryover initiative from the 2014 Work plan. The report, expected to be issued in FY 2015, will review billing practices among SNFs from FYs 2011-2013.
- Questionable billing patterns for Part B services during nursing home stays – This initiative appeared on both the FY 2013 and FY 2014 Work Plans and is expected to now be issued in FY 15. The report will review billing patterns provided to nursing home residents that are not covered under Part A.
- State Agency verification of deficiency corrections – This initiative is also a carry-over from the FY 2013 and FY 2014 Work Plans. The OIG will be reviewing whether SAs are verifying that facilities have implemented the plans of correction that they submitted for survey deficiencies. This is expected to be issued in FY 2015.
- Program for national background checks for long–term care employees – This initiative was announced in the FY 2014 Work Plan with an expected delivery date of FY 2017, but it is now expected in FY 2015. The OIG will be reviewing procedures used by participating States to ensure LTC providers are conducting background checks on prospective employees and to determine the costs of providing these checks. CMS recently announced that extensions for the National Background Check Program may be available.
- Hospitalizations of nursing home residents for manageable and preventable conditions – This is a new addition to the Work Plan, but is not a topic that we aren’t all quite familiar with. The OIG already reviewed nursing home resident hospitalizations in a 2013 report, and this report will reviewed preventable/manageable conditions developed in a nursing home that require hospitalization. This report is expected in FY 2015.
View the OIG’s FY 2015 Work Plan.