The National Association for Medical Direction of Respiratory Care

The Washington Watchline

The 2016 Office of Inspector General Work Plan

For 2016, The Office of Inspector General (OIG) of Health and Human Services, the largest inspector general's office in the Federal Government, will be continuing to increase its focus on provider compensation in the Medicare program through implementation of sophisticated data analytics and predictive algorithms. OIG’s independent and objective oversight of the programs and operations of HHS are shaped by legislative and budgetary requirements. The great majority of the OIG’s work is focused on Medicare and Medicaid programs with roughly three quarters of its total funding


2015 has been a busy year for the NAMDRC leadership. In addition to assembling a cutting edge annual meeting and pursuing an active advocacy agenda, the organization has taken the lead in establishing an approach to the problem of respiratory compromise developing in the hospitalized patient.

The 2016 Physician Fee Schedule Expands Physician Compare

Starting in 2006, both the Medicare Payment Advisory Commission and Congress expressed the belief that providing beneficiaries with information regarding physician practices would help them make informed decisions about their choice of physician and encourage clinicians to improve the quality of care they provide. To establish this policy, the Affordable Care Act required that the Centers for Medicare and Medicaid Services (CMS) to develop an internet website, Physician Compare, with information on physicians enrolled in the Medicare program.

CMS Moves To Publicly Benchmark Physician Care

Concerns about medical errors and the quality of care have led Congress to pass legislation establishing programs in Medicare that measure the performance of physicians and health care organizations and that promote public profiling of providers on dedicated websites. The Centers for Medicare and Medicaid Services (CMS) is under statutory mandate to continue to refine and expand the quality performance information published on the Physician Compare website.

The Impact of the 2016 IPPS on Pulmonary Practices

The Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) final rule established several changes to hospital compensation that will impact inpatient pulmonary practices. Of particular interest are changes to pulmonary related metrics, associated with financial penalties, including pneumonia readmission and mortality measures, the COPD mortality measure and management of severe sepsis and septic shock.

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