decisionhealth Newsletters, Part B News - 2016 Issue 7 (July)
OIG cites lax oversight of provider-based clinics, urges elimination of pay disparity
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Article Overview
This article discusses an OIG report focused on provider-based physician clinics owned by hospitals and the Medicare payment and oversight issues associated with that designation. It explains why the topic matters for hospitals, clinics, and coders by summarizing concerns about billing oversight, contractor consistency, reporting gaps, and recent policy actions affecting provider-based payment differences.
Why This Topic Matters
The article is relevant to professionals who work with hospital outpatient billing, Medicare compliance, and clinic designation policy because it addresses oversight concerns and payment changes tied to provider-based status.
What You Will Learn
- The general Medicare oversight issues associated with provider-based clinic designation
- Why provider-based payment differences are under scrutiny
- What types of monitoring and reporting concerns are discussed
- How CMS and Congress are described as responding to the issue
Who Should Read This
- Medical coders
- Hospital compliance staff
- Revenue cycle professionals
- Healthcare administrators
- Medicare billing specialists
Codes Discussed
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