decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Anti-Kickback Advisory Opinion Summaries / 1997 OIG Advisory Opinions / Opinion 97-02 - Paying ESRD Premiums Okay When State Offers to All Chronic Patients
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Article Overview
This article summarizes a 1997 Office of Inspector General advisory opinion about a state-funded end-stage renal disease assistance program administered through a university. It explains the general structure of the program, the patient eligibility framework, and why the arrangement was viewed as acceptable under the opinion. The piece is relevant to compliance professionals, dialysis providers, and coding/billing staff who monitor ESRD-related program arrangements and anti-kickback advisory guidance.
Why This Topic Matters
It helps readers understand how the OIG evaluated a publicly funded ESRD premium-assistance arrangement and what kinds of program features were important in that review.
Article Sections
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Summary of the advisory opinion
An overview of the opinion and the general compliance issue addressed by the OIG.
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State-funded ESRD program structure
A description of the program’s administration, participating providers, and the broad way assistance was organized for eligible patients.
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OIG assessment of the arrangement
The factors discussed by the OIG in evaluating the program under the advisory opinion.
What You Will Learn
- The general subject of the 1997 advisory opinion
- How the ESRD assistance program was structured at a high level
- What compliance considerations were discussed in the OIG review
- Which stakeholders may find the opinion relevant
Who Should Read This
- Compliance officers
- Dialysis providers
- Revenue cycle and billing teams
- Health care attorneys
- Medical coding professionals
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