Survey Finds Many U.S. Medical Schools, Residencies Teach Medicare, Medicaid Compliance

HHS Plans to Develop, Distribute More Educational Resources

October 27, 2010 04:25 pm News Staff

Although U.S. medical schools and specialty training programs are not required to provide instruction on Medicare and Medicaid laws aimed at preventing fraud and abuse, almost half of schools and more than two-thirds of institutions offering postgraduate training do so, according to a survey from the HHS Office of Inspector General, or OIG.

"We recognize that medical schools and institutions offering residency and fellowship programs face enormous challenges in providing a comprehensive medical education to their students and physicians-in-training," the OIG said in an executive summary of the survey(oig.hhs.gov). "Despite these challenges, many reported providing fraud and abuse training in 2010."

To facilitate those efforts, the OIG plans to develop and distribute more training materials on Medicare and Medicaid compliance issues, which should be good news to family medicine educators and family physicians with patients insured through the two government programs.

The materials "could provide medical schools and hospitals with a consistent starting point on which to build their training programs and would support OIG's efforts to promote voluntary compliance," the agency said in the executive summary.

The survey was completed by 131 medical school deans and 387 designated institution officials, or DIOs. According to the results, 44 percent of accredited allopathic and osteopathic medical schools and 68 percent of institutions offering residency and fellowship programs reported instructing students and trainees on Medicare and Medicaid fraud and abuse laws in 2010.

In medical schools, most instruction took place in the classroom and covered federal laws, such as the civil False Claims Act, which addresses fraudulent billing of the federal government; the anti-kickback statute, which involves influencing the referral of federal health care program business; and the physician self-referral statute, which prohibits physicians from referring patients to facilities in which they have a financial interest.

In the residency and fellowship programs, instruction most often was provided in conferences and lectures.

Greater percentages -- 92 percent of the medical school deans and 90 percent of the DIOs surveyed -- said they would be interested in OIG-provided instructional materials relating to Medicare and Medicaid fraud and abuse laws.

As a result, the OIG said that it will

  • prepare educational materials appropriate for medical schools and institutions offering residency and fellowship programs;
  • distribute the materials to the medical schools and institutions; and
  • seek feedback from medical schools and institutions on ways to improve the materials, such as by including emerging compliance challenges that physicians, hospitals and other providers face.

According to the executive summary, the OIG historically "has dedicated significant resources to promoting the adoption of compliance programs and encouraging health care providers to incorporate integrity safeguards into their organizations as an essential component of a comprehensive antifraud strategy."


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