decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Balanced Budget Act of 1997 / Increased civil offenses and civil money penalties
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Article Overview
This article explains how the Balanced Budget Act of 1997 expanded civil enforcement tools tied to fraud-and-abuse compliance, including penalties related to kickbacks and the use of excluded individuals. It is written for compliance, coding, billing, and reimbursement professionals who need to understand the general regulatory changes, the organizations involved, and the practical importance of screening against exclusion lists.
Why This Topic Matters
These statutory changes affect compliance risk, provider screening practices, and enforcement exposure. Understanding the article helps organizations recognize why exclusion checks and contractor oversight are operationally important.
Article Sections
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Overview of Balanced Budget Act enforcement changes
Introduces the legislative changes discussed in the article and places them in the context of federal fraud-and-abuse enforcement.
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Civil money penalty provisions
Summarizes the article’s discussion of new civil penalty authority and the broad categories of conduct addressed.
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OIG excluded provider list
Describes the role of federal exclusion resources and the general need to monitor provider status information.
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Double check your contractors
Covers general compliance considerations for verifying contractor relationships and screening practices.
What You Will Learn
- How the article frames civil enforcement changes under the Balanced Budget Act of 1997
- What broad compliance areas are affected by expanded civil money penalty authority
- Why exclusion screening resources are relevant to provider compliance programs
- How contractor oversight fits into exclusion-risk management
Who Should Read This
- Healthcare compliance professionals
- Billing and reimbursement staff
- Practice managers
- Healthcare administrators
- Legal and regulatory affairs teams
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