OIG Releases Special Advisory Bulletin on Consultant Practices - Department of Health and Human Services, Office of the Inspector General - Brief Article

Healthcare Financial Management, August, 2001

The HHS Office of inspector General (OIG) has issued a special advisory bulletin to alert providers to potentially fraudulent practices of consultants concerning Federal healthcare programs. Among the practices highlighted by the OIG are:

* Posing illegal or misleading representations regarding the consultant's relationship with the Medicare program, the Centers for Medicare and Medicaid Services (CMS--formerly HCFA), or the OIG;

* Making unreasonable or improbable promises and guarantees that can be realized only by some form of misconduct;

* Encouraging abusive practices, such as fraudulent billing schemes; and

* Discouraging compliance efforts.

The OIG acknowledges that providers have many bona fide reasons to use the legitimate services of consultants, including accountants, attorneys, business advisers, and reimbursement specialists. The agency notes that responsible consultants not only help providers develop and maintain effective business practices, but also strengthen the integrity of the nation's healthcare system.

The special bulletin, however, addresses the small number of unscrupulous consultants who engage in improper practices or encourage abuse of the Medicare and Medicaid programs. The OIG warns, "If a consultant's advice seems too good to be true, it probably is."

Calling the advisory bulletin "another tool for each provider's compliance tool box," Assistant Inspector General for Legal Affairs Lewis Morris addressed the Senate Committee on Finance on June 27, 2001, on Medicare and Medicaid provider and consultant vulnerabilities. His testimony can be found at http://www.os.dhhs.gov/progorg/oig/testimony/index.htm.>

COPYRIGHT 2001 Healthcare Financial Management Association

COPYRIGHT 2001 Gale Group