Medicare program; fraud and abuse; civil monetary penalties and exclusions for assistants at cataract surgery--HHS. Final rule with comment period.
This final rule implements section 9307 of Pub. L. 99-272, the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended by section 1895(b)(16) of Pub. L. 99-514, the Tax Reform Act of 1986, by providing the imposition of civil monetary penalties (CMPs) and exclusions against physicians billing the Medicare program or program beneficiaries for services of an assistant at surgery for cataract operations where prior approval has not been granted. The purpose of these regulations is to strengthen existing OIG penalty and exclusion authorities, and to prevent specific abusive and fraudulent practices against the Medicare program with regard to the use of assistants at surgery where not medically necessary.
D002387:Cataract Extraction / Q000191:economics*; D003415:Crime; D005251:Fees, Medical / Q000331:legislation & jurisprudence*; D005607:Fraud; D006801:Humans; D006278:Medicare / Q000331:legislation & jurisprudence*; D009872:Operating Room Technicians / Q000191:economics; D014481:United States; D014483:United States Dept. of Health and Human Services