decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Medical Specialties / Psychiatry-Psychology / OIG Advisory Opinion No 99-11 - Group May Use Local Residents to Treat Patients for Free or Reduced Fee
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Article Overview
This article reviews an OIG advisory opinion addressing a nonprofit coalition of psychotherapists that may use residents from local teaching hospitals to provide care at no charge or at reduced fees. It is relevant to psychiatry and psychology practices, hospital training programs, compliance professionals, and administrators evaluating referral arrangements, patient access issues, and fraud-and-abuse concerns in behavioral health settings. The article focuses on the arrangement’s structure, the compliance considerations cited by the OIG, and the community-benefit context supporting the opinion.
Why This Topic Matters
Healthcare organizations involved in behavioral health collaborations need to understand when service arrangements may raise fraud-and-abuse concerns and how OIG evaluates nonprofit, training-related, and access-to-care justifications.
What You Will Learn
- The general structure of the reviewed behavioral health arrangement
- Why the OIG viewed the arrangement as posing limited fraud-and-abuse risk
- How resident training and community access considerations factor into the opinion
- What types of organizations and stakeholders may find the advisory opinion relevant
Who Should Read This
- Psychiatrists
- Psychologists
- Behavioral health administrators
- Hospital compliance staff
- Medical billing and coding professionals
- Health law and compliance professionals
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