On October 1, U.S. Department of Health and Human Services (DHHS) Office of the Inspector General (OIG) issued its FY 2011 Work Plan, providing its list of priorities over the next year. Among the issues, OIG plans to examine Medicare DSH payments, which the plan notes have increased at a steady rate in recent years; hospital admissions with conditions coded as present on-admission; home health agency profitability trends; the impact of Centers for Medicare & Medicaid Services’ and the states’ enforcement measures on improving quality in poor performing nursing homes; and payments for high-cost diagnostic tests. In addition, OIG will look at potentially excess Medicaid payments for inpatient and outpatient services; transparency within nursing home ownership; Medicaid incentive payments for nursing home quality of care performance measures; and various aspects of Medicaid’s payment of pharmaceutical claims.
About Sam Fish
Sam Fish has over 40 years of legal experience in federal and state human services laws and programs, having joined PCG in 1995 after serving as Chief Counsel, Region I, for the U.S. Department of Health and Human Services for more than 25 years. At PCG, Sam provides legal advice and counsel and has served on many projects that required legal research and interpretation and implementation of many federal and state laws.
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