In its August 15, 2023, Enforcement listserv notice, the U. S. Department of Health and Human Services Office of Inspector General (“OIG”) published its Work Plan Updates for August. This article will highlight three of the five published updates:
Maintaining Buprenorphine Treatment for Medicare Enrollees With Opioid Use Disorder
CMS’s Office of Evaluations and Inspections will conduct the study – Report Expected in 2024. This study will look at the extent to which people enrolled in Medicare Part D maintain buprenorphine treatment for at least six months. It also will examine how these enrollees differ from enrollees who do not maintain treatment, including the role played by the setting in which they start their treatment and the services they receive during the treatment.
Audit of Health Centers’ Use of COVID-19 Supplemental Grant Funding and Reimbursement From The HRSA COVID-19 Uninsured Program
Health Resources and Services Administration’s Office of Audit Services – Report Expected in 2024
The audit will determine whether selected Transitional Living Program grant recipients provided services to youth experiencing homelessness according to federal requirements.
Medicare Part B Payments for Over-the-Counter COVID-19 Tests During the PHE Demonstration
CMS’s Office of Audit Services – Report Expected in 2024
On April 4, 2022, CMS launched the Medicare Over-the-Counter COVID-19 Test (OTC test) Demonstration to cover and pay for OTC tests for people with Medicare Part B benefits, including people enrolled in Medicare Advantage plans, for the remainder of the COVID-19 Public Health Emergency. During the demonstration period, Medicare covered for each enrollee up to eight OTC tests per calendar month. If an enrollee received more than eight OTC tests in a calendar month and did not have additional health coverage, the enrollee may have had to pay out-of-pocket costs for the extra tests.
The audit will determine whether Medicare paid eligible pharmacies and health care providers for OTC tests according to the demonstration’s guidelines.
The full summary of the Audit Work Plan Updates is available for viewing. Should you need anything else on this topic or related matters, or if you have a matter you wish to pursue with NYSDOH or OIG, please reach out to Matthew Babcock at firstname.lastname@example.org to discuss an engagement.
This alert is not a substitute for advice of counsel on specific legal issues.
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