decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Investment and Ownership / Compliance Tips and Tools / CMS,OIG Team Up To Create Specialty Hospital Plan
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Article Overview
This short compliance article explains why physician investment in specialty hospitals raises fraud-and-abuse concerns and how CMS and OIG frame the issue. It is aimed at physicians, administrators, and compliance professionals who need a high-level overview of the relevant federal enforcement landscape, referral transparency, and ownership-related risk areas. The article also references the Stark Law and the Anti-Kickback Statute in connection with investment relationships and patient referrals.
Why This Topic Matters
Physician ownership arrangements can create compliance risk if they are tied to referrals or other improper financial relationships. Understanding the broad CMS and OIG perspective helps organizations evaluate specialty hospital investments and related referral practices more carefully.
What You Will Learn
- Why physician investment in specialty hospitals can raise fraud-and-abuse concerns
- How CMS and OIG are positioned in relation to specialty hospital compliance oversight
- What general compliance areas are relevant to investment relationships with referral sources
- Why disclosure and documentation practices matter in ownership-related referral scenarios
Who Should Read This
- Physicians
- Hospital administrators
- Compliance officers
- Health care counsel
- Revenue cycle and coding compliance professionals
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