On November 21, 2013, the Office of Inspector General (“OIG”) published its Strategic Plan for 2014-2018. The Plan outlines the OIG’s vision for achieving its mission to protect the Department of Health and Human Services (“DHHS”) through a number of goals and priorities. The OIG intends to use the Plan as a guide when determining where to focus its resources and as a way to benchmark its progress.
Specifically, the Plan identifies four broad goals:
1. Fight Fraud, Waste, and Abuse 2. Promote Quality, Safety, and Value
3. Secure the Future
4. Advance Excellence and Innovation.
Each of the goals is also undergirded by a number of priorities. For example, as part of its goal to Fight Fraud, Waste, and Abuse, the OIG will:
• Identify, investigate, and take action when needed • Hold wrongdoer’s accountable and maximize recovery of public funds • Prevent and deter fraud, waste, and abuse
While the Goals and Priorities are designed to be flexible so that the OIG can address new challenges as they arise, the Plan includes a number of “key focus areas.” Under the OIG’s priority to “identify, investigate, and take action when needed,” it plans to apply the lessons learned from the Medicare Fraud Strike Force teams to other HHS programs in order to improve enforcement results. Other key focus areas reflecting the various goals and priorities in the Plan include:
• Identifying and recover improper payments • Utilizing exclusions and referrals for debarment to protect HHS programs and beneficiaries.
• Promoting compliance with Federal requirements and resolving noncompliance • Assessing whether providers and suppliers, grantees, and others are qualified to participate in Government programs • Promoting quality of care in nursing facilities and home- and community-based settings • Investigating prescription drug fraud cases
• Improving the privacy and security of personally identifiable information • Improving the security and integrity of electronic health records.
The OIG’s Strategic Plan is likely to be reflected in its upcoming 2014 Work Plan, which sets forth the OIG’s plans and projects for the calendar year. The 2014 Work Plan is scheduled to be released in January.
For more information regarding this and related issues, please contact Adrienne Dresevic, Esq., or Carey Kalmowitz, Esq. at (248) 996-8510, (212) 734-2128 or visit the HLP website.