The U.S. Department of Health and Human Services (HHS) Office of Inspector General’s (OIG) publishes a work plan that, “is dynamic and adjustments are made throughout the year to meet priorities and to anticipate and respond to emerging issues with the resources available.” The agency updates the work plan on the website monthly, and projects listed in the work plan include the Centers for Medicare & Medicaid Services (CMS), Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), as well as many other administrative health agencies. ALN monitors the HHS OIG work plan for trends and issues in the agency’s priorities.
In January 2019 most of the work plan updates centered around CMS. Of interest to those monitoring the trends regarding the opiate crisis in the work plan, one update focused on the utilization and pricing trends for Naloxone in Medicaid. Naloxone is a medication designed to rapidly reverse opioid overdose. To determine how to increase Naloxone access to Medicaid-eligible beneficiaries, the proposed data brief would:
- trend utilization of and expenditures of Naloxone in Medicaid over five years;
- determine how the cost-per-dose or Naloxone under Medicaid compares to other prices;
- determine the proportion of all Naloxone distributed in the U.S. paid under Medicaid between 2014-2018.
Other updates included a review of the new clinical diagnostic laboratory test payments in 2018; follow up on inpatient claims subject to the Post-Acute-Care Transfer policy; and an update by the Office of Audit Services on duplicate payments for home health services. While we know our clients are interested in these work plan updates, we also know they do not have the time to follow every change each month. ALN is happy to keep up with the updates, so our clients can benefit.