decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Billing Services / Sanctions for prohibited payment arrangements
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Article Overview
This premium article covers Medicare billing-services compliance guidance on prohibited payment arrangements and the resulting contractor response when a carrier or intermediary identifies a problem. It is intended for billing staff, compliance teams, providers, and reimbursement professionals who need to understand the general scope of the policy and the types of administrative follow-up it can trigger.
Why This Topic Matters
Understanding this topic helps billing and compliance teams recognize when payment arrangements may raise Medicare program concerns and what administrative actions may follow.
What You Will Learn
- How Medicare billing-services compliance guidance addresses prohibited payment arrangements.
- What type of contractor response is described when an arrangement is found to be problematic.
- What general administrative follow-up can accompany this type of Medicare issue.
- How this topic relates to billing, compliance, and provider payment administration.
Who Should Read This
- Billing professionals
- Compliance officers
- Providers
- Reimbursement specialists
- Healthcare administrators
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