Home Health & Hospice Week

Plus: Feds plan nationwide audits on advanced care planning.

A federal watchdog agency wants to clear the way for Unified Program Integrity Contractors to detect waste, fraud, and abuse.

So indicates a new item on the HHS Office of Inspector General’s Work Plan. UPICs “are the only benefit integrity contractors that safeguard both the Medicare and Medicaid programs,” the OIG says in a new post. “UPICs must effectively detect and deter fraud, waste, and abuse.”

The study will examine the results from UPICs’ “identification and investigation of fraud, waste, and abuse. It also will identify any barriers and challenges UPICs have experienced while conducting unified benefit integrity activities across Medicare and Medicaid,” the OIG says of the report expected in 2022.

Another issue the OIG will tackle is “Telehealth Expansion During COVID-19 Emergency” under Medicaid.

“Rapid expansion of telehealth may pose challenges for State agencies and providers, including State oversight of these services,” the OIG says in a new Work Plan addition. “Our objective is to determine whether State agencies and providers complied with Federal and State requirements for telehealth services under the national emergency declaration, and whether the States gave providers adequate guidance on telehealth requirements,” the agency says of the report expected some time next year.

And the OIG also will investigate “Advanced Care Planning Services: Compliance With Medicare Requirements,” according to a new topic posted to the Work Plan.

Reminder: “In 2016, Medicare began paying for Ad­vanced Care Planning (ACP), which is a face-to-face service through which a Medicare physician (or other qualified health care professional) and a patient discuss the patient’s wishes for health care if he or she becomes unable to make decisions about care,” the OIG recaps.

“Previous reviews have shown improper payments due to a lack of clinical documentation to support face-to-face services, clinical documentation of the time spent discussing ACP, or both,” the agency says of the report expected in 2021. “We plan to perform a nationwide audit to determine whether Medicare providers for ACP services complied with Federal regulations.”

The OIG’s 264 active Work Plan items are at https://oig.hhs.gov/reports-and-publications/workplan/active-item-table.asp.