As Pandemic Eases, OIG Ramps Up Audits

Why This Topic Matters

It helps healthcare organizations understand which broad compliance areas are receiving renewed federal attention so they can monitor risk and prepare for audits.

Article Sections

1. Introduction

   Sets the context for renewed federal compliance activity as pandemic-related pressures ease and audit oversight increases.

2. Top OIG targets

   Introduces the main Work Plan audit areas highlighted for providers, coders, and compliance teams.

3. Audit of CARES Act Provider Relief Funds

   Discusses oversight of pandemic relief funding and related review of provider eligibility and payment processes.

4. Audits of Medicare Part B Telehealth Services During the COVID-19 Public Health Emergency

   Covers planned review activity involving telehealth services furnished under Medicare Part B during the public health emergency.

5. Medicare Telehealth Services During the COVID-19 Pandemic. Program Integrity Risks.

   Addresses broader program integrity review of telehealth billing patterns in Medicare claims data during the pandemic period.

6. Audits of Medicare Part B Laboratory Services During the COVID-19 Pandemic

   Summarizes review of laboratory service billing trends during the pandemic, including changes in utilization and testing activity.

7. Audit of Medicare Payments for Inpatient Discharges Billed by Hospitals for Beneficiaries Diagnosed With COVID-19

   Describes oversight of inpatient payment activity associated with hospital discharges involving beneficiaries diagnosed with COVID-19.

8. CMS Oversight of the Two-Midnight Rule for Inpatient Admissions

   Reviews ongoing CMS-related inpatient admission oversight and short-stay claim scrutiny under the Two-Midnight Rule.