November 16, 2015
The Department of Health and Human Services Office of Inspector General (HHS-OIG) recently released its FY 2016 Work Plan, in which it identified key areas of focus for the upcoming year. Consistent with its mandate to detect fraud, waste, and abuse, and to hold accountable those who do not meet program requirements or who violate Federal health care laws, the OIG’s Work Plan outlines several enforcement initiatives. As a result of the its enforcement initiatives in FY 2015, the OIG excluded over 4,000 individuals and entities from Federal health care program participation and expects to recover over $3 billion in Federal health care program payments. The 2016 Work Plan runs the gamut of the healthcare industry and offers providers a valuable tool for staying ahead of OIG’s enforcement and recovery initiatives.

What Providers Should Know

OIG’s FY 2016 Work Plan makes clear that OIG remains committed to ensuring that Federal health care program funds are appropriately used and are recouped where necessary. The OIG conducts audits, evaluations, and investigations to uncover instances of health care fraud and abuse and can impose civil monetary penalties (CMP) where appropriate. Given that CMPs under both the FCA and the Civil Monetary Penalties Law are set to increase by virtue of the newly enacted Bipartisan Budget Act of 2015, it is more important than ever for providers to ensure that they are in compliance with the multitudinous rules and regulations governing the provision of health care services. Health care providers should use the Work Plan as a tool to guide their compliance efforts both now and in the future. For help understanding the initiatives outlined in the Work Plan and how they might impact your entity, please contact Polsinelli.

For an overview of important aspects of the Work Plan, click here.