ABSTRACT
Introduction During the late 1980s the issue of healthcare compliance relative to fraud, abuse, false claims, and a host of other problems became a major concern for all healthcare providers. Since then, although concerns about all aspects of healthcare compliance gained momentum, those related to the highly technical areas involving coding, billing, reimbursement, and a multitude of payment systems increased even more dramatically. These concerns have now continued into the 21st century. This book is devoted to healthcare compliance concerns in the area of coding, billing, and reimbursement. Allied issues such as documentation, computer systems, payment systems, information resources, and the like are also considered. Among the many associated areas of concern are
• Federal tax laws • State tax laws • OSHA • Employee-and employment-related issues • Financial compliance • Antitrust • HIPAA privacy and security • Americans with Disabilities Act • Environmental Protection Act
Corporate compliance programs are designed to address all of the compliance areas for healthcare providers. The CBR (coding, billing, and reimbursement) compliance program concentrates on an area of great concern for statutory compliance (e.g., Medi care, Med icaid, and other government programs) and contractual compliance (e.g., managed care contracts).
