decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Anti-Kickback Advisory Opinion Summaries / 1999 OIG Advisory Opinions / Opinion 99-02 - Ambulance Service Discount for SNFs' PPS Patients Denied if Not Also Given to Medicare
Subscribe or sign in to view the full article.
Article Overview
This short advisory-opinion summary covers a proposed ambulance discount arrangement involving skilled nursing facility residents and explains how the Office of Inspector General evaluated it under the Anti-Kickback Statute and related safe harbor guidance. It is relevant for compliance, billing, and legal review teams that monitor fraud-and-abuse risk in provider contracting and payer-specific pricing arrangements.
Why This Topic Matters
The article highlights how payer-specific discount structures can raise fraud-and-abuse concerns and why advisory opinions matter for evaluating proposed business arrangements before implementation.
What You Will Learn
- How the OIG analyzed a proposed discount arrangement under anti-kickback safe harbor concepts
- Why payer-specific pricing can create compliance concerns in health care contracting
- What broad fraud-and-abuse issues may arise in arrangements involving facility residents and referral relationships
- How advisory opinions can inform compliance review of proposed service discounts
Who Should Read This
- Compliance officers
- Health care attorneys
- Billing and reimbursement professionals
- Provider contracting teams
- Ambulance service administrators
- Skilled nursing facility administrators
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com