decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Specialty Service Referral Arrangements / Anti-Kickback Statute - Referral Agreements for Specialty Services Safe Harbor
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Article Overview
This article covers a federal safe harbor governing referral arrangements for specialty services under the Anti-Kickback Statute. It is relevant to physicians, specialists, compliance staff, and billing/coding professionals who need to understand the general conditions surrounding reciprocal referral agreements, how the arrangement is framed under federal law, and why these arrangements can matter for Medicare and state health care program reimbursement relationships.
Why This Topic Matters
Referral arrangements between providers can raise compliance concerns when federal health care program payments are involved. This article helps readers recognize the type of specialty-service arrangement addressed by the safe harbor and understand the broader regulatory context.
What You Will Learn
- The general compliance context for specialty-service referral arrangements
- How the article frames the safe harbor under federal regulation
- Why reciprocal referral arrangements can be important in Medicare and state program settings
- The kinds of parties and provider relationships discussed in the safe harbor context
Who Should Read This
- Physicians
- Specialists
- Compliance officers
- Medical coders
- Billing professionals
- Health care administrators
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