decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
OIG Investigation Procedures / Investigation for Assignment Agreement Violations
Subscribe or sign in to view the full article.
Article Overview
This article covers the process used to review alleged Medicare assignment agreement violations, with emphasis on how complaints are investigated, what happens after a violation is identified, and the broader enforcement framework used by CMS and OIG. It is intended for readers who need a high-level understanding of Medicare payment assignment obligations, related administrative actions, and the distinction between ordinary billing disputes and more serious enforcement cases.
Why This Topic Matters
Understanding assignment agreement enforcement helps providers, compliance staff, and auditors recognize how Medicare complaints are handled and what agencies may do when billing exceeds permitted charges. It also clarifies why these matters can escalate into administrative remedies or civil money penalty-related activity.
What You Will Learn
- How Medicare assignment agreement complaints are initially reviewed
- What follow-up actions may occur after an assignment violation is identified
- How CMS and OIG fit into the enforcement process
- The general types of remedies discussed for repeated or serious violations
- What kinds of records may be relevant in an investigation
Who Should Read This
- Healthcare providers
- Medical billing staff
- Compliance officers
- Medicare contractors
- Healthcare auditors
- Health law and reimbursement professionals
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com