OIG work plan targets SNF therapy billing, background checks

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The U.S. Department of Health and Human Services Office of Inspector General will take aim at the payment system for skilled nursing facilities as part of its Fiscal Year 2016 Work Plan.

The plan includes a review of the prospective payment system for SNFs and the documentation requirements for claims paid by Medicare. OIG also plans to review whether claims by SNFs were paid “in accordance with Federal laws and regulations,” following its September report blasting therapy overbilling.

The 2016 work plan, which was released last week, also includes plans to report on the progress of the National Background Check Program for long-term care employees who have direct patient access. The program, now in its fourth year, was established as part of the Affordable Care Act. Participation in the program is currently voluntary for states, with Connecticut and West Virginia the most recent joiners.

OIG recovered more than $3 billion through audits and investigations, and reported 925 criminal and 682 civil actions for crimes against HHS programs in Fiscal Year 2015, according to the work plan.