decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Anti-Kickback Advisory Opinion Summaries / 1999 OIG Advisory Opinions / Opinion 99-03 - DME Distributor May Discount Mattresses to SNFs
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Article Overview
This premium article covers a 1999 Office of Inspector General advisory opinion involving a durable medical equipment distributor, skilled nursing facilities, and a proposed mattress pricing arrangement. It explains the general compliance issues reviewed by the OIG, including discounted bundled pricing, cost reporting treatment, and the potential for referral-related concerns under Medicare payment arrangements. The summary is intended for compliance professionals, coders, and healthcare administrators who need a high-level understanding of the advisory opinion without the full text.
Why This Topic Matters
Advisory opinions like this help organizations understand how federal fraud-and-abuse oversight may view pricing and reimbursement structures involving post-acute care providers. Readers working in healthcare compliance, billing, or contracting can use the article to identify whether the underlying opinion is relevant to facility purchasing and Medicare reimbursement processes.
What You Will Learn
- The general facts and purpose of the advisory opinion request
- How the OIG evaluated the proposed pricing arrangement at a high level
- What compliance themes were relevant to Medicare payment and cost reporting
- Why the arrangement was viewed in the context of fraud-and-abuse risk
Who Should Read This
- Healthcare compliance professionals
- Medical coders and reimbursement staff
- Skilled nursing facility administrators
- Durable medical equipment suppliers
- Healthcare attorneys and auditors
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