The Department of Health and Human Services Office of Inspector General (OIG) issued its Fiscal Year 2008 Work Plan on October 1, 2007. The OIG annual Work Plan gives an advance preview of what issues the OIG has on its radar for the upcoming year.

The OIG stated in its opening message of the Work Plan that it will continue to concentrate its efforts in evaluating and investigating Medicare and Medicare programs, representing 80% of its resources.  The remaining 20% of the OIG resources will be spent on public health and human services programs.

Target areas for the OIG in 2008 include: Long Term Care Hospitals (LTCHs), patient care and safety at physician-owed specialty hospitals, accreditation of hospitals, and “place of service” for physician coding.

With regard to Long Term Care Hospitals, OIG plans to more closely whether payments for interrupted stays made to LTCHs were correct. An “interruption of stay” occurs when a Medicare inpatient is discharged from the LTCH to another facility and then returns to the LTCH.

OIG will also monitor physician-owed specialty hospitals more carefully by reviewing indicators of patient care and safety to determine whether the hospitals are in compliance with the Medicare Conditions for Participation for Hospitals. The OIG stated that staffing requirements at physician-owed specialty hospitals will be evaluated.

The OIG will examine the policies and procedures of the Centers for Medicare and Medicaid Services (CMS) with regard to Joint Commission accreditation of hospitals.      In 2004, the Joint Commission started allowing hospitals to evaluate themselves. The OIG will study whether the CMS policies and procedures involving hospital accreditation are adequate.

The OIG stated that they will also scrutinize “place of service” for physician coding at ambulatory surgical centers (ASCs) and hospital outpatient departments to ensure that the proper codes are claimed. Medicare normally pays physicians more when they provide care in non-facility settings, such as in their office, as compared with a hospital outpatient department.

The 2008 OIG Work Plan is located online at

http://oig.hhs.gov/publications/docs/workplan/2008/Work_Plan_FY_2008.pdf