Outpatient Facility Coding Alert - 2004 Issue 14
Fraud & Abuse: Double-Dipping Could spell double trouble
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Article Overview
This article summarizes an HHS Office of Inspector General warning about extra patient charges in physician care arrangements and the potential Medicare fraud-and-abuse implications. It is relevant to physicians, compliance staff, and medical billers who work with Medicare-participating practices and want to understand the broad regulatory issues raised by bundled patient-care packages, assignment concerns, and possible penalties.
Why This Topic Matters
It helps readers recognize a compliance risk area involving patient charges and Medicare-covered services, which can lead to enforcement action, exclusion concerns, or civil money penalties.
What You Will Learn
- The general compliance issue discussed in the OIG alert
- Why extra patient charges can create Medicare assignment concerns
- How physician care packages may raise fraud-and-abuse questions
- The potential enforcement consequences mentioned in the alert
Who Should Read This
- Physicians
- Medical practice administrators
- Compliance officers
- Medical billers and coders
- Revenue cycle staff
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