decisionhealth Newsletters, Part B News - 2004 Issue 9 (September)
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Article Overview
This article addresses a compliance question involving Holter monitoring services billed in a physician-to-physician arrangement. It explains the general anti-kickback and referral concerns that can arise when equipment is provided without charge and why the issue matters to physicians, coders, and practice managers working with Medicare-related billing and referral relationships.
Why This Topic Matters
Physician practices may encounter billing and referral arrangements involving shared equipment or services, and this piece highlights why those arrangements can raise compliance concerns under federal anti-kickback law.
What You Will Learn
- How a physician equipment-sharing arrangement can raise compliance concerns
- Why referral relationships can matter when equipment is provided without charge
- General alternatives discussed for avoiding potential legal problems in monitoring service workflows
- The compliance perspective relevant to Medicare-related physician billing arrangements
Who Should Read This
- Medical coders
- Physicians
- Practice managers
- Compliance officers
- Health care attorneys
Codes Discussed
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