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Compliance Related Links
The websites listed at the URL's below were not created nor are they maintained, or managed by the University of Florida and thus we make no representations or warranties regarding the condition or functionality of any web sites or pages listed below, their suitability for use, or that these web pages will be uninterrupted or error-free. The University of Florida further makes no representations about the suitability of any content, information or software made accessible via the links listed below, for any purpose.
FEDERAL RELATED COMPLIANCE LINKS
Centers for Medicare and Medicaid Services - CMS
Top page for CMS
The Official U.S. Government Site for People with Medicare.
Medicare Beneficiary Publications
Medicare Physician Guide
Medicaid Fraud Statutes
(A comprehensive listing of official State statutory citations that are used to prosecute civil or criminal fraud, or those used to maintain program integrity or to combat program abuse.)
CMS Public Affairs
The Centers for Medicare & Medicaid Services Media.
CMS Practicing Physicians Advisory Council
Available in either PDF or HTML formats.
Medicare/Medicaid Program Manuals
CMS Manuals, Transmissions, and Memoranda.
(Medicare Hospital Manual - .zip file)
Medicare Statistics & Data
(CMS data, statistics, and research information)
Medicare Learning Network
Medicare education and training for physicians, suppliers, and providers.
Documentation Guidelines for Evaluation and Management Services
A subsection of the Medicare Learning Network.
Physicians Regulatory Issues Team (PRIT)
A subsection of the Medicare Learning Network.
CMS Open Door Initiative
12 monthly and bi-monthly open door forums as well as several special forums to focus on issues specific to Medicare and Medicaid. Each forum is chaired by a senior-level agency official and co-chaired by a CMS Regional Administrator who report directly to Administrator Scully.
ICD-9-CM Coding for Diagnostic Tests
Information and examples for assigning diagnostic codes.
HHS/OIG - Office of Audit Services (OAS)
Home Page: U.S. Department of Health and Human Services
National Correct Coding Initiative
Government Research Center: NTIS Database.
U.S. Government Printing Office
Resources available through the G.P.O. to include the Federal Register, Code of Federal Regulations and other Federal government documents.
Office of Management and Budget
Office of Managment and Budget (OMB) site. Track when a CMS or OIG regulation has gone to the OMB and when it has been released.
House Budget Committee's home page
U.S. Department of Justice home page
O.I.G. main page
(O.I.G. Work Plans).
U.S. Health & Human Services Personnel Directory
Directory serch for U.S. Department of Health & Human Services. Find a CMS or OIG official by using this personnel locator. Includes search engines for both telephone numbers and e-mail addresses.
Internet resource for text of proposed and passed Congressional legislation.
General Accounting Office
Reports and testimony from the investigative arm of Congress.
US General Services Administration
Allows searchs of parties excluded from transacting business with the Federal Government. Users must sign in to perform searches.
Chapter IV -- PART 415 -- Services Furnished By Phsicians In Providers, Supervising Physcians In Teaching Settings, and Residents In Certain Settings
Medicare Claims Processing Manual Chapter 12 - Physicians/Nonphysician Practitioners Adobe Reader required.
ICD-9-CM Official Guidelines For Coding and Reporting Adobe Reader required.
Corporate Responsibility and Corporate Compliance Adobe Reader required.
A Resource for Health Care Boards of Directors
1995 Documentation Guidelines for Evaluation & Management Services Adobe Reader required.
1997 Documentation Guidelines for Evaluation and Management Services Adobe Reader required.
Draft Evaluation & Management Documentation Guidelines (June 2000) Adobe Reader required.
Transmittal 811: Pub 100-04 Medicare Claims Processing Adobe Reader required.
I. SUMMARY OF CHANGES: Incorporating material from Transmittal 1780, dated November 22, 2002, which was inadvertently omitted from the Medicare Claims Processing Manual, Pub.100-04. Also, adding documentation requirements for electronic medical records under §100A; adding code G0344 to the primary care exception list under §100.1.1C, per the Final Rule of November 15, 2004; and updating anesthesia policy under §100.1.2A per the Final Rule of November 7, 2003.
Transmittal 788: Pub 100-04 Medicare Claims Processing Adobe Reader required.
I. SUMMARY OF CHANGES: This transmittal revises the Medicare Claims Processing Manual, Pub.100-04, Chapter 12, Section 30.6.10 with the correct new CPT codes for 2006 to use for follow-up visits and second opinion evaluations beginning January 1, 2006. The AMA CPT codes 99261 - 99263 (hospital inpatient follow-up consultations) and codes 99271 - 99275 (confirmatory consultations) have been deleted beginning 2006. This transmittal addresses consultation policy clarifications regarding the definition, documentation requirements, when and by whom a consultation may be performed/reported, a split/shared evaluation and management service, and nonphysician practitioners. The consultation examples are revised and updated.
Transmittal 1776: Medicare Carriers Manual Part 3 - Claims Process Adobe Reader required.
Section 15501 Evaluation and Management Service Codes – General. Subsection B is revised to address payment for E/M services provided by physicians and non-physician practitioners (NPP) and also shared evaluation and management services between a physician and an NPP in the same group practice. (Also restores language erroneously deleted from the first paragraph of subsection A.)
Carriers need not search their files to either retract payment for claims already paid or to retrospectively pay claims.
Transmittal 1780: Medicare Carriers Manual Part 3 - Claims Process Adobe Reader required.
Section 15016, Supervising Physicians in Teaching Settings, is revised to clarify the documentation requirements for evaluation and management (E/M) services billed by teaching physicians. The revised language makes it clear that for E/M services, teaching physicians need not repeat documentation already provided by a resident. In addition, the revisions clarify policies for services involving students and other issues and update regulatory references.
NON-GOVERNMENTAL COMPLIANCE LINKS
American Health Information Management Association
Medicare Compliance Alert
Home page of Medicare Compliance Alert, with link to Internet listerv devoted to health fraud.
The Health Law Resource
Created by William Manning, a health attorney, this page is intended as a resource for health care practitioners, professionals or anyone interested in learning more about the dynamic field of health care law, and more specifically, the regulatory and transactional aspects of health care law practice.
American Health Lawyers Association
The Healthcare Company (HCA)
Includes their Corporate Integrity Agreement and other information about their compliance program (click on "Ethics & Compliance").
American Hospital Association
American Bar Association
Health related links from the ABA
Compliance Main Page College of Medicine home page
Webmaster <email@example.com>College of Medicine, Office of Compliance
This page updated 4/6/09 Please read our disclaimer and permitted use statement.