decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Fraud and Abuse / OIG's physician compliance guidance
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Article Overview
This article explains the Office of Inspector General’s compliance guidance for individual and small group physician practices. It covers the purpose and scope of the guidance, the role of internal controls and compliance programs, and the distinction OIG draws between innocent billing errors and conduct that may trigger fraud and abuse liability. The article is relevant to physicians, practice managers, compliance staff, and billing professionals looking for a general understanding of physician practice compliance expectations.
Why This Topic Matters
The guidance helps smaller physician practices understand how federal compliance expectations apply to everyday billing and operational processes. It is important for practices that want to reduce risk, address overpayments appropriately, and align internal policies with fraud-and-abuse compliance concerns.
What You Will Learn
- The purpose and scope of OIG’s physician practice compliance guidance
- How the guidance is intended to help small and individual physician practices
- The general distinction between billing errors and fraud-related conduct
- Why internal controls and compliance programs matter for physician practices
- How practices should think about overpayments and error reduction
Who Should Read This
- Physicians
- Small group practice administrators
- Medical practice managers
- Compliance officers
- Medical billing staff
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