CMS Issues New Compliance Tool for Providers

In October, CMS posted its first issue of a new educational newsletter called the “Medicare Quarterly Provider Compliance Newsletter.” This newsletter is intended to help physicians, providers, and suppliers understand how to avoid certain billing errors and other improper activities. The newsletter will …

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What the OIG Guidance on Permissive Exclusion Means for Owners and Managers

For quite some time, the Office of Inspector General (OIG) has had the authority to exclude an owner, officer and/or manager of an entity convicted of certain criminal offenses or that is excluded from participation in Federal health care programs. In section 6502 of the Patient Protection and Affordable Care Act …

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OIG Intends to Exclude Officers and Managing Employees of Sanctioned Entities: Limited Safety Zones

On October 20, 2010, the OIG released a notice setting forth non-binding factors the OIG will consider in assessing whether to impose permissive exclusion in accordance with section 1128(b)(15)(A)(ii) of the Social Security Act, which authorizes the OIG to exclude any officer or managing employee of a sanctioned …

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OIG Approves Limited Insurance Pre-Authorization Services

On September 28, 2010, the OIG released Advisory Opinion No. 10-20, which permits a physician-owned imaging center to offer free insurance pre-authorization services for its own services. Of course, before the OIG begins its analysis, it states that the OIG’s position on arrangements where goods or services are …

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Another OIG Opinion Calms Fears Government May Punish Charities Helping Poor People Dying From Brain Tumors

At first blush, the conclusion seems obvious. But OIG Advisory Opinion 10-12 reminds us that calling something “charity” doesn’t immunize it from careful scrutiny under the fraud and abuse laws. This opinion, released August 30, is the latest of several OIG opinions addressing patient assistance programs, or …

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OIG Issues Advisory Opinion Concerning Joint Ventures

The old French proverb “the more things change, the more they stay the same” comes to mind as one reads the HHS Office of the Inspector General’s most recent statements about joint ventures between heath care providers.  On September 8, 2010, the OIG issued an Advisory Opinion concerning a joint venture …

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