COMPLIANCE PLANS

OIG Monthly Work Plan Review: March 2019

This month, there were 16 new Work Plan items. Three of these may have implications for some labs as detailed below.

Medicare Market Shares of Mail Order Diabetes Test Strips

Issue: The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) requires HHS-OIG to determine the market shares of diabetes test strips (DTS) supplied via mail order to ensure that Competitive Bidding Program contract bids cover at least 50 percent, by volume, of the DTS types provided to Medicare beneficiaries. This is known as the “50-percent rule.”

OIG Action: The Bipartisan Budget Act of 2018 amended the 50-percent rule by requiring the use of data from mail order and non-mail order Medicare markets. OIG has been conducting Medicare market share evaluations for DTS provided via mail order since 2010.

Medicaid Fraud Control Units Fiscal Year 2018 Annual Report

Issue: OIG provides guidance to the Medicaid Fraud Control Units (MFCUs), assesses MFCUs’ compliance with Federal regulations and policy, and evaluates MFCUs’ adherence to published performance standards.

OIG Action: This annual report will analyze the statistical information that was reported by the MFCUs for 2018, describing in the aggregate the outcomes of MFCU criminal and civil cases. It will also identify trends in MFCU case results.

Potential Duplication of NIH Research Grant Funding

Issue: The National Institutes of Health (NIH) has 27 Institutes and Centers that manage research initiatives that include awarding grant funding. The Departments of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019 (Public Law No. 115-245) and its Accompanying Report directed that OIG examine the NIH’s oversight of its grantees’ compliance with NIH policies, including NIH efforts to ensure the integrity of its grant application and selection processes.

OIG Action: OIG plans to review NIH’s efforts to ensure the integrity of its grant application and selection process by testing NIH’s internal controls for identifying and addressing potentially duplicative grant funding and overlap within its 27 Institutes and Centers. The objective of the review will be to determine whether NIH’s internal controls were effective in ensuring that grantees did not receive duplicative NIH grant funding.

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