Oct 1st, 2014
The Office of Inspector General (OIG) issued on September 18 a Special Advisory Bulletin (SAB) and an Office of Evaluations and Inspections (OEI) report that discussed the potential Anti-kickback issues for pharmaceutical companies and pharmacies associated with offering co-payment and/or discount coupons. The SAB defines co-payment coupons as “any form of direct support offered by a manufacturer ...
Aug 2nd, 2013
Since the expansion of new Health Insurance Portability and Accountability Act (HIPAA) regulations, which redefines who is considered a business associate by covered entities under the Health Information Technology for Economic and Clinical Health (HITECH) Act, the Anti-kickback Statute and Stark (physician self-referral) Laws haven’t been in the limelight as a compliance focus for many ...
In CMS
Nov 15th, 2012
By Mary Pat Whaley, CPC, FACMPE In health care, we are “blessed” with an abundance of rules, policies, standards, and laws. Three important regulations are the False Claims Act, Stark Law, and Anti-Kickback Statute, which you should not only know about, but should be actively managing via a robust compliance plan. To help keep your ...
Nov 1st, 2012
By David Lane, PhD, CHC, CPC, CAPPM “Compliance” often conjures up images of boring lectures, law enforcement, huge fines, scary “I’m from the government and I’m here to help” mentality, and worse. In reality, compliance is an integral part of the health field. And with health care reform and the Patient Protection and Affordable Care ...
Aug 1st, 2010
Understand the risks if you miscode. By Michelle A. Dick When claims for provider services aren’t coded and billed properly, financial liability often falls on the provider. What happens when the coder or biller is to blame for sloppy coding or claims processing? Do coders need to pay? Individual Liability for Fraudulent Billing The Federal ...