Medicare Compliance & Reimbursement

Staffing companies that contract with physicians to staff emergency rooms and other hospital departments could soon face considerably more oversight from the Centers for Medicare & Medicaid Services. Staffing companies are in an unusual situation as far as Medicare goes, because they're not directly permitted to bill Medicare - instead, claims for services provided by their physicians are processed under the individual physicians' names. But that situation presents a potential threat to the integrity of the Medicare program, the General Accounting Office maintains in a new report. Since staffing companies can't be reassigned Medicare benefits and bill Medicare directly, they "remain largely invisible to the oversight efforts" of CMS, the GAO says in "Medicare Provider Enrollment: Opportunities to Enhance Program Integrity Efforts" (GAO-03-185). Both the GAO and CMS say Congress should pass legislation requiring staffing companies to enroll in Medicare. Lesson Learned: Physician staffing companies, long sheltered from many Medicare regulatory burdens, could soon face the same kind of oversight as that imposed on other health care organizations. To see the report, go to http://www.gao.gov/new.items/d03185.pdf.