decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Diagnostic Tests / Fraud Alerts / Joint ventures
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Article Overview
This premium article reviews an Office of Inspector General fraud alert concerning joint venture arrangements in health care. It explains the general compliance concerns raised by these relationships, the types of entities and service lines involved, and why the topic matters for providers, compliance staff, and coding or billing professionals working with diagnostic and other reimbursable services.
Why This Topic Matters
It helps readers recognize the compliance significance of certain ownership and referral arrangements in settings such as diagnostic testing and related supplier services. Understanding the scope of the alert can support screening of business relationships in organizations that bill federal health care programs.
What You Will Learn
- The general focus of an OIG fraud alert on joint venture arrangements
- The kinds of health care business relationships discussed in the alert
- Why referral-linked ownership arrangements can raise compliance concerns
- The broad categories of services and suppliers mentioned in connection with these arrangements
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Healthcare administrators
- Physician practice managers
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