decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Anti-Kickback Advisory Opinion Summaries / 2000 OIG Advisory Opinions / Opinion 00-04 - OIG Approves Referral Programs That Uses Few Federal Dollars
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Article Overview
This summary explains an Office of Inspector General advisory opinion concerning a physician-network referral program tied to a preventive-care service for chronically ill patients. It is relevant to healthcare compliance, medical practice operations, and fraud-and-abuse risk review because it discusses why the arrangement was viewed as low-risk from a federal program standpoint and how the program’s structure affected the analysis.
Why This Topic Matters
Compliance teams, physicians, and healthcare administrators may use this article to understand how the OIG evaluates referral-based arrangements, especially where federal healthcare dollars are limited and the relationship between referrals and compensation is closely examined.
What You Will Learn
- How an OIG advisory opinion can evaluate a physician referral program
- What general factors may influence fraud-and-abuse review of a preventive-care network arrangement
- How federal program participation can affect the compliance analysis of a referral-based business model
- Why the article is relevant to Medicare-related compliance and healthcare operations
Who Should Read This
- Healthcare compliance professionals
- Physicians
- Medical practice administrators
- Healthcare attorneys
- Revenue cycle and risk management staff
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