The Office of the Inspector General (OIG) has an active Work Plan for the federal oversight and evaluation of reimbursements, funds and services rendered through the Centers for Medicare & Medicaid (CMS) as well as for other departments and agencies such as: Centers for Disease Control and Prevention (CDC), Administration for Children and Families (ACF), Administration on Community Living (ACL), Health and Human Services (HHS). The OIG adheres to the standards established by the Government Accountability Office (GAO), Department of Justice (DOJ) and the Inspector General community. Activities for auditing and monitoring are listed with a timeline and reviews with findings published on compliance, fraud, failures and waste.With the passing of the Opioid Bill H.R.6 and related substance abuse treatment legislation passed in 2017 and earlier this year, monitoring activities for these services and funds by the OIG will continue to increase. The 2017 Part C and Part D Program Audit and Enforcement Report and the Medicare Payment for Clinical Diagnostic Laboratory Tests were submitted this past spring and fall respectively. The OIG is on track for both auditing and compliance reviews. Forthcoming reports include the Opioid State Targeting Response Grants and Review of State’s Oversight of Opioids.
Providers and systems of care expanding treatment to substance abuse treatment should be prepared for administrative, management, and clinical audits. With the provisions to increase treatment access, the enforcement of compliance for treatment standards is an integral step in monitoring and auditing.
With longstanding excellence and knowledge in treatment standards for varying levels of care for both behavioral health and substance abuse, SAE has assisted providers as an external auditing consultant. SAE’s Management and Clinical Audit team is available to perform quantitative and qualitative reviews of management and clinical oversight activities, including chart reviews, with summative and directive recommendations to improve compliance to treatment standards.
To learn more about SAE’s Management and Clinical Audit Services, email info@saeassociates.com to connect with our team.