decisionhealth Newsletters, Coder Pink Sheets - 2007 Issue 1 (January)
Avoid quid-pro-quo co-management relationships with optometrists
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Article Overview
This article explains compliance issues surrounding co-management relationships between ophthalmologists and optometrists in the context of cataract surgery. It is aimed at physicians, optometrists, coders, and compliance staff who need to understand Medicare anti-kickback concerns, safe-harbor concepts, and patient consent considerations related to post-operative care arrangements.
Why This Topic Matters
These arrangements can create fraud and abuse risk if they are set up as automatic referral exchanges. Understanding the compliance concerns helps practices reduce legal exposure and document patient preferences appropriately.
Article Sections
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Co-management relationship concerns
Introduces the compliance risk discussed in the article and frames the issue around ophthalmology and optometry co-management arrangements.
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Medicare and OIG compliance context
Summarizes the regulatory backdrop and the organizations referenced in connection with post-operative care arrangements.
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Recommended patient communication and documentation
Covers general preoperative communication and documentation considerations for transfer of care and post-operative follow-up.
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Example practice approach
Describes a practice workflow presented in the article as an example of how care transfer communication may be handled.
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Coder resource
Points readers to an external resource related to anti-kickback statutes.
What You Will Learn
- The compliance issues raised by ophthalmology and optometry co-management arrangements.
- How Medicare and OIG concerns relate to post-operative care coordination.
- The types of patient communication and written documentation discussed in the article.
- A general example of how a practice may document care transfer decisions.
Who Should Read This
- Physicians
- Ophthalmologists
- Optometrists
- Medical coders
- Compliance staff
- Practice administrators
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