Labs Among Top 10 Management Challenges Facing HHS

The U.S. Department of Health and Human Services (HHS) Office of Inspector General recently spotlighted 10 top management challenges it says the HHS is facing in 2017—and laboratory issues figure prominently in the list.

The #1 challenge listed is Ensuring Program Integrity for the Medicare program which the OIG says includes three categories: reducing improper payments, preventing and addressing fraud and abuse, and “Fostering Prudent Payment Policies.” With regard to payment policies, the agency notes that the Centers for Medicare & Medicaid Services has several tasks to complete for implementation of the Protecting Access to Medicare Act of 2014 (PAMA) and “[t]imeframes for some of these tasks are tight.” The OIG also reiterates its concern about “risks to payment accuracy” because the agency will be relying on laboratories to self-identify who should report and self-attest to the accuracy of their own reporting.

Despite acknowledging that the agency has made “substantial strides” in fighting fraud, the OIG says “more must be done to protect Medicare from fraud, waste and abuse and extend the solvency of the program.”

Other challenges included in the top 10 include:

#2 Oversight of Medicaid and managed care

#3 Secure and efficient use and exchange of electronic health information

#4 Improving financial and administrative management of HHS programs which total $1 trillion in costs

#5 Oversight of more than $400 billion in HHS grants benefiting public health

#6 Addressing misuse of drugs under Medicare Part D and Medicaid

#7 Protecting vulnerable populations with regard to safety and quality of health care services—including children and patients of nursing homes, hospice and home health programs

#8 Operating and overseeing the health insurance marketplaces

#9 Managing reforms to health care delivery and strengthening Medicare Advantage

#10 “Ensuring the safety of food, drugs and medical devices”