A Roadmap for New Physicians
Where To Go for Help

What To Do If You Think You Have a Problem Compliance Programs for Physicians

When you are considering whether or not to engage in a particular billing practice; enter into a particular business venture; or pursue an employment, consulting, or other personal services relationship, it is prudent to evaluate the arrangement for potential compliance problems. The following is a list of possible resources that can help you.

Experienced health care lawyers can analyze your issues and provide a legal evaluation and risk analysis of the proposed venture, relationship, or arrangement.
The Bar Association in your State may have a directory of attorneys in your area who practice in the health care field.
Your State or local medical society may be a good resource for issues affecting physicians and may have listings of health care lawyers in your area.
Your specialty society may have information on additional risk areas specific to your type of practice.
CMS's local contractor medical directors are a valuable source of information on Medicare coverage policies and appropriate billing practices.
CMS's "Medicare Physician Guide: A Resource for Residents, Practicing Physicians, and Other Health Care Professionals" (PDF) , provides an overview of the Medicare program and information on Medicare reimbursement and payment policies.
The OIG's Web site provides substantial fraud and abuse guidance.
As discussed above, OIG issues Compliance Program Guidance documents that include compliance recommendations and discussions of fraud and abuse risk areas.
OIG issues advisory opinions to parties who seek advice on the application of the AKS, CMPL, and Exclusion Authorities. Information on how to request an OIG advisory opinion and links to previously published OIG advisory opinions are available in the OIG Advisory Opinions section.
CMS issues advisory opinions to parties who seek advice on the Stark law. Information on how to request a CMS advisory opinion and links to previously published CMS advisory opinions are available at on the Advisory Opinions section of the CMS Web site.