decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Medical Specialties / Ophthalmology-Optometry / OIG Advisory Opinion No 99-7 - Coinsurance Waiver Approved for Nonprofit's Ophthalmologists
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Article Overview
This premium article reviews an OIG advisory opinion about a nonprofit ophthalmology program and whether an across-the-board waiver of beneficiary coinsurance could be permitted under federal law. It is relevant to ophthalmology, optometry, compliance, and billing professionals who need to understand the general regulatory context, the organization involved, and the factors OIG considered in reaching its opinion.
Why This Topic Matters
The article helps readers understand how beneficiary cost-sharing policies can be evaluated in a healthcare fraud-and-abuse context, especially for nonprofit eye-care programs and participating physicians.
What You Will Learn
- The regulatory framework discussed in the advisory opinion
- How a nonprofit eye-care program’s billing and cost-sharing approach was evaluated
- The compliance factors OIG considered in relation to beneficiary inducements and provider participation
- Why the opinion is relevant to ophthalmology and optometry practices
Who Should Read This
- Ophthalmologists
- Optometrists
- Healthcare compliance professionals
- Medical coders and billing staff
- Healthcare attorneys
- Nonprofit clinic administrators
Codes Discussed
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