Billing company compliance program guidelines published by OIG.
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Biomedical subjects
Publications and source records attributed to P A Avery.
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On August 14, 1995, the Health Care Financing Administration (HCFA) published a long-awaited final rule implementing the Ethics in Patient Referrals Act (Stark I). In conjunction with this final rule, HCFA intends to survey hospitals and physicians to obtain information necessary to evaluate compliance with the Omnibus Budget Reconciliation Act of 1993 amendments to the Stark Act (Stark II), most of which took effect on January 1, 1995.
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Beginning a year ago, with the issuance of the first RFP to service recipients in five southeast Michigan counties, Michigan has sought to control the rising cost of providing health care services to Medicaid recipients through the use of managed care contracting.
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On Dec. 1, 1998, the Office of the Inspector General (OIG) of the Department of Health and Human Services published its Compliance Program Guidance for Third-Party Medical Billing Companies to assist companies in the development of compliance programs to promote adherence to applicable laws.
On Jan. 4, the Health Care Financing Administration (HCFA) issued final regulations implementing the Stark II ban on physician self-referral. These final regulations, which go into effect Jan. 4, 2002, are described as "Phase I" since they address only a portion of the Stark law. HCFA promises that additional final regulations implementing the remaining portions of the Stark II ban will be published at a future date. This article provides a brief overview of the highlights of the Phase I final regulations.