Although these programs have provided considerable benefits to many people, they have come under fire for a variety of reasons. Critics argue that the programs are too costly for the services provided, many are wasteful and inefficient, and, because of poor monitoring, these programs are often routinely abused by unscrupulous medical practitioners who defraud the system. To address billing fraud, the Office of the Inspector General (OIG) now aggressively investigates questionable billing to the Health Care and Finance Administration (HCFA), which oversees Medicare and Medicaid. The OIG expects all providers to implement and audit a compliance plan, that is, a comprehensive procedure and audit manual that demonstrates diligence in correct billing and avoidance of fraud. A new industry of consultants and legal advisors emerged during the 1990s and continue to assist practices with their compliance plans.
This is the end of the preview. Sign up
access the rest of the document.