Part B Insider (Multispecialty) Coding Alert
OIG Offers 'Roadmap' for Avoiding Fraud and Abuse
Plus: Medicare payment suspension is serious business.
The OIG recently asked medical schools whether they would like the OIG to provide educational materials in teaching medical students about fraud and abuse, and the overwhelming majority responded with a resounding "yes!" In response to the request, the agency has published a new document to help physicians stay on the straight and narrow.
The new publication, entitled "Roadmap for New Physicians: Avoiding Medicare and Medicaid Fraud and Abuse" summarizes the five main federal fraud and abuse laws, and offers tips regarding how doctors can comply with the laws. Those five laws are the False Claims Act, the Anti-Kickback Statute, the Stark Law, the Exclusion Statute, and the Civil Monetary Penalties Law.
The document isn't just for medical students " if you feel you could use a refresher on any of these fraud and abuse topics, check out the OIG's Roadmap at http://oig.hhs.gov/fraud/PhysicianEducation/.
In other news...
Once you're on a Medicare payment suspension, you shouldn't expect to get off it any time soon.
In a new report, the OIG examines Medicare payment suspensions that CMS imposed on providers in 2007 and 2008. Of 253 suspensions during that time, CMS removed suspensions for only three providers based on rebuttals, says the report. However, only 41 of the 253 providers even submitted rebuttals for their suspensions (suspensions are not appealable).
Most of the suspensions in the time period occurred in Florida, Puerto Rico, California, and Michigan, the OIG notes. More than half of the suspensions occurred in Medicare Fraud Strike Force areas. The overpayments totaled "at least" $206 million, the OIG says.
CMS imposed most of the suspensions due to fraud suspicions. Therefore, only a few of the suspended providers received advance notice of the payment suspension, the report adds.
More details are in the report at http://oig.hhs.gov/oei/reports/oei-01-09-00180.pdf.
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OIG Offers 'Roadmap' for Avoiding Fraud and Abuse
Plus: Medicare payment suspension is serious business. The OIG recently asked medical schools whether they [...]
