decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Gainsharing Arrangements / OIG's Special Advisory Bulletin
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Article Overview
This premium article reviews an OIG Special Advisory Bulletin from July 8, 1999, focused on gainsharing arrangements in the hospital-physician setting. It explains the general compliance and fraud-and-abuse context addressed by the bulletin, including civil money penalties and related federal prohibitions. The article is intended for healthcare compliance professionals, coders, billing staff, and others who need to understand how the bulletin frames these arrangements under federal law.
Why This Topic Matters
Gainsharing arrangements can raise compliance concerns for hospitals and physicians, and this bulletin is a key reference for understanding the federal legal issues surrounding them. Readers use this article to orient themselves to the OIG’s discussion of civil money penalties and related statutes before evaluating their own policies or contracts.
What You Will Learn
- The compliance context for gainsharing arrangements in hospital-physician relationships
- The federal fraud and abuse laws referenced by the OIG bulletin
- Why the bulletin is relevant to Medicare and Medicaid payment arrangements
- How the article frames the OIG guidance historically and administratively
Who Should Read This
- Healthcare compliance professionals
- Medical coders
- Billing specialists
- Physicians
- Hospital administrators
- Revenue cycle staff
Codes Discussed
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