tci Medicare Compliance & Reimbursement - 2011 Issue 11
Compliance: Is Your Doctor 'Absent-Minded?' That Excuse Won't Fly With OIG
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Article Overview
This article reviews a range of Medicare compliance and fraud-and-abuse topics discussed by OIG speakers in a provider training session. It is aimed at Part B practices, compliance staff, and administrators who need a broad understanding of current enforcement priorities, organizational safeguards, and reporting obligations. The material covers documentation expectations, lease-related self-referral concerns, overpayment handling, emerging compliance program requirements, claim review practices, and electronic health record security.
Why This Topic Matters
The article highlights compliance areas that can affect billing, enrollment, and privacy practices in outpatient and physician settings. It helps readers recognize the types of operational issues that may draw government scrutiny and understand the general categories of controls and processes discussed by OIG and CMS.
What You Will Learn
- The main compliance themes emphasized in an OIG provider training session
- How documentation, leasing, and payment integrity issues fit into broader fraud-and-abuse oversight
- What general compliance-program elements and electronic security concerns were discussed for Part B practices
- How provider practices may be affected by government review and enforcement priorities
Who Should Read This
- Physician practices
- Part B providers and suppliers
- Compliance officers
- Practice administrators
- Billing and revenue cycle staff
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