SNF operators can use OIG’s managed care reports and unimplemented recommendations to anticipate where enforcement pressure on MA plans is heading.
The growth of managed care over the last several years has changed fundamental aspects of the Medicare and Medicaid programs. This significant shift transformed how the government pays for and covers health care for approximately 100 million enrollees.
The OIG has designated oversight of managed care as a priority area. OIG has developed a strategy to align its audits, evaluations, investigations, and enforcement of managed care. The HHS-OIG Strategic Plan for Oversight of Managed Care for Medicare and Medicaid has three goals:
Resources available include:
HHS-OIG. “Managed Care.” HHS Office of Inspector General, 9 Jan. 2024. https://oig.hhs.gov/reports/featured/managed-care/.
✔ Comply with every payer's rules
✔ Equip your team with the Playbook
✔ Monitor rates and payer trends
