Medicare Compliance & Reimbursement

Monitoring home health agencies will be high on the OIG's priority list this year, according to the agency's 2012 work plan.

The HHS Office of Inspector General has added two new topics regarding HHA oversight to its work plan: "States' Survey and Certification of Home Health Agencies: Timeliness, Outcomes, Follow-up, and Medicare Oversight" and "Medicare Administrative Contractors' Oversight of Home Health Agency Claims."

Its three other new HHA topics for the coming year are "Missing or Incorrect Patient Outcome and Assessment," "Questionable Billing Characteristics of Home Health Services," and "Wage Indexes Used To Calculate Home Health Payments."

The five new topics join four existing HHA topics on the work plan: "Medicare's Oversight of Home Health Agencies' Patient Outcome and Assessment Data," "Home Health Agency Claims' Compliance With Coverage and Coding Requirements," "Home Health Prospective Payment System Requirements," and "Home Health Agency Trends in Revenues and Expenses."

In contrast, hospices see relatively light action in the new work plan. The OIG lists only two topics for the industry -- one new ("Hospice Marketing Practices and Financial Relationships with Nursing Facilities") and one existing topic ("Medicare Hospice General Inpatient Care"). The OIG had indicated in a recent report on hospice nursing home problems that it would add the nursing facility topic.

See more details on each topic in the work plan at http://oig.hhs.gov/reports-and-publications/workplan/index.asp#current.