OIG unveils compliance guidelines for ambulance providers - Policy Watch - Brief Article

Healthcare Financial Management, May, 2003

The HHS Office of Inspector General (OIG) published compliance program guidance for ambulance providers in the March 24, 2003, Federal Register. The rule provides guidelines for ambulance providers to develop a sound compliance program that fits their needs. The guidelines focus on compliance measures related to services furnished primarily under the Medicare program and, to a limited extent, other federal healthcare programs. However, ambulance providers are free to address private payer claims and services in their compliance program.

The intent of the guidance is to reduce the number of fraudulent and abusive practices in the ambulance transport industry, such as improper transport of individuals, medically unnecessary trips, trips claimed but not rendered, false documentation, and payment of kickbacks. The agency recommends that ambulance providers develop a compliance program that includes written policies and procedures, education and training, and internal monitoring and reviews.