University of Illinois Nationwide Review of the Administration Discussion Post

This week we will review OIG Work Plan items. The Office of Inspector General publishes areas that the agency will audit and review. For those of you who are not familiar with the OIG please review the following site : http://oig.hhs.gov/.

The Work Plan page is found HERE and specific work plan items are found HERE.

Essentially, the agency is in charge of detecting fraud and abuse and independently performs audits of healthcare facilities as well as government agencies and even Medicare contractors. In turn, recommendations are then issued to Medicare and Medicaid contractors which may or many not become future audit areas. It is not uncommon to be contacted by the OIG for an audit. When this occurs HIM is often pulled in at some point during the process.

Additionally, HIM professionals are often charged with reviewing the OIG Work Plan and determining whether any areas within their facility need attention. There has been much more discussion in the last couple of years pertaining to the EMR and copy and paste functionality which weakens the integrity of the medical record and jeapordizes the reliability of the information found within. I personally am very interested in what the OIG finds.

1.Review the workplan items and find those that focus on ambulatory sites which include Part B benefit areas. You will need to click on each hyperlink to obtain more information.

2. Discuss one audit area that grabbed your attention.

3. What are the risks and how can HIM help (if at all) in minimizing the overall risk to the organization? 1