decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Fraud Alerts / OIG Special Fraud Alerts / Special Fraud Alert_March 1998 / Kickbacks
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Article Overview
This premium alert explains the Office of Inspector General’s March 1998 guidance on potential kickback risks in hospice and nursing home relationships. It is relevant to compliance, billing, and contracting staff who need a high-level understanding of fraud and abuse concerns tied to referrals and payments in federal health care programs. The article focuses on the general compliance issues raised by these arrangements and the types of contractual features that warrant review.
Why This Topic Matters
Hospice and nursing home financial relationships can create fraud and abuse exposure if they are structured in a way that could influence referrals or compensation. Understanding the OIG’s concerns helps organizations review contracts and payment arrangements for compliance risk.
What You Will Learn
- The general anti-kickback compliance concerns raised by the OIG
- Why hospice and nursing home payment arrangements may attract scrutiny
- How contract language and payment structure can create fraud and abuse risk
- What types of organizational relationships are highlighted in the alert
Who Should Read This
- Compliance officers
- Medical coders
- Billing staff
- Contract managers
- Healthcare administrators
- Revenue cycle professionals
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