Outpatient Facility Coding Alert - 2008 Issue 7
COMPLIANCE: Peruse This Breakdown of the OIG's Report
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Article Overview
This article summarizes examples from the HHS Office of Inspector General’s 2006 Health Care Fraud and Abuse Control Program report. It is aimed at readers who follow healthcare compliance, auditing, fraud and abuse enforcement, and provider billing integrity, and it highlights broad categories of misconduct and government recoveries without detailing coding guidance.
Why This Topic Matters
The piece helps compliance and revenue cycle audiences understand the kinds of conduct the OIG reported in 2006 and why enforcement activity matters to healthcare organizations, providers, and billing staff.
Article Sections
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Physician fraud
Examples involving physician-related misconduct and enforcement outcomes are summarized in this section.
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Nonphysician practioners
This section covers compliance issues involving a nonphysician provider category and related government actions.
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Device manufacturers
This section discusses alleged kickback activity involving a medical device company and associated settlement activity.
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Podiatrists
This section reviews provider billing misconduct associated with podiatry services and enforcement consequences.
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Chiropractors
This section summarizes a chiropractic case involving billing, restitution, and prison sentencing.
What You Will Learn
- How the OIG’s 2006 report is organized around different provider and industry categories
- What broad types of fraud and abuse cases were highlighted by the OIG
- How compliance failures can affect physicians, nonphysician practitioners, device manufacturers, podiatrists, and chiropractors
- Why enforcement examples in an OIG report are relevant to healthcare compliance monitoring
Who Should Read This
- Healthcare compliance professionals
- Medical billing and coding staff
- Revenue cycle teams
- Practice managers
- Healthcare auditors
- Provider organizations
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