tci Medicare Compliance & Reimbursement - 2003 Issue 22
Ambulance: AMBULANCE SUBSCRIPTION PLAN STEERS PAST KICKBACK PERILS
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Article Overview
This article reviews an HHS Office of Inspector General advisory opinion involving an ambulance provider subscription plan that takes the place of collecting Medicare Part B copays. It explains the general fraud-and-abuse issue raised by routine waiver of cost sharing, why the arrangement was analyzed, and what compliance-minded ambulance organizations may want to understand when evaluating similar subscription programs.
Why This Topic Matters
Ambulance providers and compliance staff need to understand how subscription-based billing arrangements can intersect with Medicare Part B cost sharing and anti-kickback concerns.
What You Will Learn
- How an HHS OIG advisory opinion can affect ambulance subscription programs
- Why Medicare Part B cost sharing is central to the fraud-and-abuse concern
- What types of compliance considerations are relevant for non-profit ambulance providers
- How to evaluate subscription arrangements at a high level for reimbursement risk
Who Should Read This
- Ambulance providers
- Compliance officers
- Medical billing professionals
- Healthcare attorneys
- Revenue cycle staff
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