On August 28, 2023, the U.S. Division of Well being and Human Services and products Administrative center of Inspector Common (“OIG”) printed a brand new “Featured Matter” webpage on controlled care oversight. The OIG’s Featured Subjects come with compilations of the OIG’s current paintings associated with a selected material house and are up to date as new subject material is printed.
Because of the expansion of controlled care and the numerous variations between fee-for-service and controlled care techniques, the OIG has designated oversight of controlled care as a concern house and has advanced a coordinated plan for controlled care oversight (the “Controlled Care Strategic Plan”). Efficient implementation of the Controlled Care Strategic Plan would require the OIG to behavior rigorous oversight of controlled care plans all over every degree of the controlled care lifestyles cycle (i.e., plan established order and contracting, enrollment, fee, and services and products). To handle the dangers related to every degree of the controlled care plan lifestyles cycle, the OIG has known 3 strategic objectives: (1) advertise get entry to to handle folks enrolled in controlled care, (2) supply complete monetary oversight, and (3) advertise records accuracy and inspire data-driven selections. Below every of those classes, the OIG has specified sure targets to battle fraud, waste, and abuse.
Controlled care plans will have to seek the advice of this Featured Matter to know doable chance spaces and learn how to cope with them. The Controlled Care Strategic Plan, in addition to different OIG controlled care assets, may also be discovered at the OIG’s new “Featured Matter” webpage on controlled care at https://oig.hhs.gov/reports-and-publications/featured-topics/managed-care/.
