Every year, the Office of Inspector General releases a Work Plan for health care services, in October. The Work Plan describes the areas of interest that the OIG will investigate in the coming year. There are sections for hospitals, nursing homes, and of course, physicians.
There are usually 12-15 topics for physicians. For each one, CMS lists the topic and gives a 2-3 sentence description of what they are investigating, and why. The descriptions are brief, and the reader is often left to interpret the why. Some of the topics are new starts (issues that the OIG is beginning to work on in the coming year) and some are works in progress (projects started the previous year, not yet complete.)
It is critical for physician practices to review the topics on the OIG Work Plan each October. Compare the OIG list to services performed in the practice. Review the coding rules for each topic on the list that is done in the practice, and decide if the practice needs an internal audit. If so, add it to the practice's own Compliance Plan for the year.