ED Coding & Reimbursement Alert - 2008 Issue 29
Compliance: Trying to Save Medicare Money? Be Careful When Sharing Savings
Subscribe or sign in to view the full article.
Article Overview
This article explains a recent OIG advisory opinion involving a hospital and physician groups that arranged to share savings from changes in operating room practices. It is relevant to compliance, health law, hospital administration, and physician practices that participate in Medicare-related arrangements. The article focuses on the regulatory concerns raised, the legal framework discussed, and the circumstances under which the arrangement was not sanctioned.
Why This Topic Matters
Shared-savings arrangements can create fraud-and-abuse risk if they are structured in a way that may influence referrals or reduce medically necessary services. Understanding the OIG’s analysis helps hospitals and physicians evaluate compliance exposure before entering similar payment arrangements.
What You Will Learn
- The general compliance issues that can arise in physician-hospital shared-savings arrangements
- How OIG advisory opinions are used to assess regulatory risk
- Why Medicare-related cost-saving incentives may trigger fraud-and-abuse concerns
- What broad factors can make a hospital-physician arrangement legally sensitive
Who Should Read This
- Compliance officers
- Healthcare attorneys
- Hospital administrators
- Physician group managers
- Medical practice coders and auditors
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com