The Health Law Sidebar
June 19, 2020

US HHS OIG Releases Annual Work Plan

The United States Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its annual Work Plan which sets out OIG audits and evaluations that are currently being conducted, as well as audits and evaluations that are planned for the upcoming fiscal year.

The mission of the HHS OIG is to uphold the integrity of the various programs offered by HHS and the well-being of the individuals who use such programs. The United States Department of Justice and the Government Accountability Office establish the professional standards to be followed by the OIG in conducting these integrity and oversight activities. Through independent and objective audits, investigations and evaluations, the OIG ensures that HHS programs are running efficiently and effectively.

In determining the priorities for the upcoming year, the OIG assesses risks in HHS programs and identifies which areas need the most attention in addition to work that is required by statute. Factors that are considered in assessing what areas need the most attention include statutory requirements, concerns raised by Congress, the biggest performance and management challenges for HHS, and the potential a project has to create a positive impact. After conducting a risk assessment and establishing the priorities for the year, information about current and future audits and evaluations to be conducted by the OIG’s Office of Audit Services and Office of Evaluation and Inspections are published in the Work Plan. The audits and evaluations performed by the OIG span widely across HHS and include the Centers for Medicare & Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), and human resources agencies such as Administration for Children and Families (ACF). In addition, the Work Plan includes projects related to State and local governments’ expenditures of Federal funds.

For the sake of transparency, the OIG updates its Work Plan website each month. In the month of June of 2020, the OIG added three Work Plan items relating to Covid-19, citing unprecedented challenges. One item will examine how Covid-19 has affected nursing homes throughout the nation, identifying certain characteristics exhibited in nursing homes most negatively affected by the pandemic. Additionally, it will put forth strategies that nursing homes have used to mitigate the effects of Covid-19. In the wake of new reporting requirements imposed by CMS on nursing homes, the OIG also has a Work Plan item related to ensuring that the data reported by nursing homes is “complete, accurate, and reliable.”

The Work Plan mentions various upcoming inspections and evaluations including:

  • Nursing Facility Staffing: Reported Levels and CMS Oversight;
  • Audit of CARES Act Provider Relief Funds-Distribution of $50 Billion to Health Care Providers;
  • Use of Telehealth to Provide Behavioral Health Services in Medicaid Managed Care;
  • Medicare Payments for Stelara; and
  • Review of Institutions of Higher Education Grantees Receiving National Institutes of Health Awards.

The Work Plan also contains a list of recently completed inspections and evaluations including:

  • Audit of HHS’s Production and Distribution of COVID-19 Lab Test Kits;
  • Audit of Child Care Development Fund Childcare Services During Coronavirus Disease 2019 Pandemic;
  • Health and Safety Monitoring in Head Start;
  • Medicaid-Audit of Health and Safety Standards at Individual Supported Living Facilities;
  • States’ Oversight of Medicaid Managed Care Medical Loss Ratios; and
  • The Food and Drug Administration’s Role in Facilitating Testing for COVID-19.

To read more about the HHS OIG’s Work Plan and to see the monthly updates, please visit the Work Plan website.

If you have any questions, please contact David R. Ross, Senior Shareholder, via e-mail at dross@oalaw.com. Law Clerk Colleen R. Pierson contributed to this article.