decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Health Plans / Overview
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Article Overview
This article provides a short overview of how health plans are treated under major federal healthcare compliance frameworks. It is relevant for compliance professionals, healthcare administrators, and billing/coding teams who need a general understanding of the subject area and the related legal/regulatory context.
Why This Topic Matters
Understanding the compliance framework around health plans helps organizations recognize where health plan arrangements intersect with fraud-and-abuse and self-referral oversight.
What You Will Learn
- How health plans are addressed in federal compliance contexts
- The general relationship between health plans and physician self-referral oversight
- The broader regulatory areas connected to health plan exemptions
- Why the topic matters for healthcare compliance review
Who Should Read This
- Healthcare compliance professionals
- Healthcare administrators
- Medical billing and coding staff
- Practice managers
- Revenue cycle teams
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