OIG Releases 2017 Work Plan

Single-use drug vial wastage and CMS’ implementation of the Quality Payment Program are in the spotlight in the Office of Inspector General’s (OIG) fiscal year 2017 Work Plan. The Work Plan, released November 10, outlines areas the OIG will scrutinize in the coming year and ongoing projects. The OIG added several items for 2017 that may affect hospitals.

The agency will look into whether MACs properly settle Medicare cost reports for Medicare disproportionate share hospital payments. The OIG believes that, due to the complex factors and number of variables that go into calculating these payments, they are at a high risk of overpayment.

Starting July 1, CMS began requiring hospitals to report modifier -JW to report drug wastage of single-use vials or other single-use packages. The OIG will analyze data reported to CMS through modifier -JW to determine the amount of waste, the amount paid for waste, and provide specific examples of how waste and cost could be reduced if the drugs were offered in a different size vial.

The OIG will also take a look at how CMS has planned for and implemented the early stages of the Quality Payment Program. The agency will evaluate CMS’ progress and identify key challenges in implementation of the program.

Among the ongoing items on the Work Plan are Medicare EHR incentive payments. The OIG released several reports this year finding that states have overpaid providers millions of dollars in EHR incentive payments.