decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Anti-Kickback Advisory Opinion Summaries / 1997 OIG Advisory Opinions / Opinion 97-01 - Donations to Charity to Fund Medicare Premiums are Okay
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Article Overview
This premium article reviews a 1997 Office of Inspector General advisory opinion about a charity-based program that helped cover health coverage costs for certain patients. It explains the compliance concerns raised, the parties involved, and the general basis for the OIG’s analysis under federal anti-kickback and beneficiary-inducement concepts. The summary is relevant to compliance, revenue integrity, dialysis-related organizations, and healthcare legal professionals monitoring charitable support programs.
Why This Topic Matters
It shows how federal fraud-and-abuse analysis can apply when outside donations support patient assistance programs connected to provider choice and Medicare-related costs.
What You Will Learn
- The compliance issues raised by charity-supported patient assistance programs
- How the OIG framed beneficiary-inducement concerns in this advisory opinion
- Why the arrangement was reviewed in the context of anti-kickback and civil monetary penalty concepts
- What role patient choice and charitable donations played in the OIG’s analysis
Who Should Read This
- Compliance officers
- Healthcare attorneys
- Revenue cycle professionals
- Dialysis organizations
- Charitable foundations
- Medical coding and reimbursement researchers
Codes Discussed
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