E/M Coding Alert - 2003 Issue 9
FRAUD & ABUSE: OIG May Dislocate Your Joint Venture
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Article Overview
This article explains HHS Office of Inspector General concerns about contractual joint ventures in healthcare, especially arrangements involving durable medical equipment suppliers and other provider relationships. It is relevant to compliance staff, healthcare executives, legal counsel, and billing/coding professionals who need a high-level understanding of fraud and abuse scrutiny and the general factors that may attract regulatory review. The discussion focuses on the types of joint ventures the OIG says may warrant attention and the broader compliance themes tied to referral-dependent business arrangements.
Why This Topic Matters
Joint ventures involving healthcare providers and suppliers can raise fraud and abuse concerns, so understanding the OIG’s warning themes helps organizations assess compliance risk before entering or expanding such arrangements.
What You Will Learn
- The general focus of HHS OIG guidance on contractual joint ventures
- Why certain healthcare joint venture arrangements may draw fraud and abuse scrutiny
- How durable medical equipment-related partnerships fit into the broader compliance discussion
- The broad factors regulators may examine in joint venture structures
Who Should Read This
- Compliance officers
- Healthcare attorneys
- Practice administrators
- Hospital and provider executives
- Durable medical equipment suppliers
- Billing and coding professionals
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