The HHS Office of Inspector General (OIG) Work Plan for Fiscal Year 2013 provides brief descriptions of activities that OIG plans to initiate or continue with respect to HHS programs and operations in fiscal year 2013. The Work Plan describes the primary objectives and provides for each review its internal identification code, the year in which we expect one or more reports to be issued as a result of the review, and indicates whether the work was in progress at the start of the fiscal year or will be a new start during the year. When reports are issued, they are posted to OIG’s website.

On page 12:
Inpatient Rehabilitation Facilities—Appropriateness of Admissions and Level of Therapy
We will examine the appropriateness of admissions to IRFs. We will also examine the level of therapy
provided in IRFs and how much concurrent and group therapy IRFs provide. IRFs provide rehabilitation
for patients who require a hospital level of care, including a relatively intense rehabilitation program and a multidisciplinary, coordinated team approach to improve patients’ ability to function. Patients must undergo preadmission screening and evaluation to ensure that they are appropriate candidates for IRF care. (42 CFR §§ 412.622(a)(3)-(5).) (OEI; 00-00-00000; expected issue date: FY 2014; new start)

On page 24:
Independent Therapists—High Utilization of Outpatient Physical Therapy Services
We will review outpatient physical therapy services provided by independent therapists to determine
whether they were in compliance with Medicare reimbursement regulations. Prior OIG work found that
claims for therapy services provided by independent physical therapists were not reasonable, medically necessary, or properly documented. Our focus is on independent therapists who have a high utilization rate for outpatient physical therapy services. Medicare will not pay for items or services that are not “reasonable and necessary.” (Social Security Act, § 1862(a)(1)(A).) Documentation requirements for therapy services are in CMS’s Medicare Benefit Policy Manual, Pub. 100-02, ch. 15, § 220.3. (OAS; W-00-11-35220;W-00-12-35220; W-00-13-35220; various reviews; expected issue date: FY 2013; work in progress and new start)