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MANAGED CARE August 2001. ©MediMedia USA
NEWS AND COMMENTARY
GAO: Consultants Point Docs Toward Federal Law Violations
The General Accounting Office has found that some health care consultants have been advising physicians to do things that conflict with federal laws and that may be unethical. GAO investigators attended and tape-recorded two consultants' workshops; one consultant told doctors to refrain from reporting overpayments from Medicare, while another was heard telling a physician it would be in his best interest to give preferential treatment to patients with higher-paying insurance plans. Consultants on the GAO tape were also found telling physicians to work their prime appointment slots around those who pay the most — as a result, limiting the time slots available for Medicare and Medicaid patients.tape-recorded two consultants' workshops. One told doctors not to report Medicare overpayments; the other told a physician to give preferential treatment to patients who have higher-paying insurance plans. Consultants also told physicians to work their prime appointment slots around those who pay the most, thus limiting the time available for Medicare and Medicaid patients.
Several consultants are being prosecuted for advising clients to follow illegal billing practices. The Office of the Inspector General has issued an advisory bulletin to warn providers that hiring a consultant does not shield them in cases of wrongdoing. It reminds physicians to be wary of consultants who make claims that appear too good to be true.