How to Prepare for the 2018 OIG Workplan

Candace Lewis, Director, Revenue Cycle Management Revenue Cycle Management (RCM)


Become and Stay in Compliance

Each year the Office of Inspector General (OIG) develops a work plan to combat fraud, waste and abuse in the health care space. Some areas they will focus on this year include:

  • Medicare Part B Payments for Psychotherapy Services

  • Review of Medicare Payments for Telehealth Services

  • Medicaid Services Delivered Using Telecommunication Systems

  • Physical Therapists-High Use of Outpatient Physical Therapy Services

Candace Lewis, Director of Revenue Cycle Management for Medical Advantage, offers several tips for practices to become and stay in compliance.

“The first step is to create and implement written policies, procedures and standards of conduct,” she says. “The second is designating a compliance officer and a compliance committee.”

The next steps involve education and communicating with staff about your practice’s compliance policy. “Conducting annual training and education for staff as well as establishing open lines of communication is also important,” Lewis said. “Monitoring your staff adherence, enforcing standards and responding promptly to detected offenses with corrective action will help maintain your practice’s compliance.”

In addition to having and publicizing rules, creating a culture of compliance within your practice is also important, according to Lewis. “Make sure current and new staff know compliance is a priority,” she said. “You can do this by identifying where your fraud and abuse risk areas are and managing your financial relationships.”

For additional help, the OIG offers these tips.