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News Brief: OIG Issues Warning on Unscrupulous Consultants

The OIG in the Department of Health and Human Services has issued a special advisory bulletin warning providers to beware of "unscrupulous consultants" who engage in improper practices or encourage abuse of the Medicare and Medicaid programs.
 
"Depending on the circumstances, these practices might expose both the consultants and their clients to potential legal liability," the bulletin states. "Hiring a consultant does not relieve a provider of responsibility for ensuring the integrity of its dealings with the federal healthcare programs." Watch out for consultants who:
 

Represent that they have an inside track to or are approved by CMS (formerly HCFA) or the OIG.
 

Promise or guarantee a specific dollar or percentage increase in Medicare reimbursements, which creates the risk that the consultant might submit false claims or prepare false cost reports on behalf of the client.
 

Encourage the hospital to commit abuses such as improper billing or false documentation.
 

Discourage the hospital's compliance efforts.
 
 The full text of the bulletin as well as related reports by the General Accounting Office and the Assistant Inspector General for Legal Affairs at HHS can be found at .

- Published on 2001-08-01