OIG Compliance

In June 2005, the Office of Inspector General (OIG) reported that 67% of all chiropractic claims are fraudulent. As a result, the OIG has significantly increased its audits of chiropractic claims and offices.

Dr. Mario Fucinari is a Certified Medical Compliance Specialist (MCS-P) and a Certified Insurance Consultant. He will provide you with an understanding of regulatory compliance issues associated with a physician’s practice environment. Arm yourself against audits, fines and litigation with a basic knowledge of the laws, rules and regulations, which effect the daily operation of a practice. Dr. Fucinari will offer fundamental compliance knowledge with solutions on how to bring an existing or new practice into regulatory compliance.

Some may know compliance, but they know little about the chiropractic office. Some know chiropractic procedures, but really don’t know about compliance. Dr. Fucinari is the first and only chiropractor to be certified as a Medical Compliance Specialist (MCS-P).

Learn how to apply compliance procedures to your practice by a full-time practitioner certified in compliance procedures. What does it really mean to do a self-audit? Procedures will be shown to bring you into compliance according to the OIG Guidelines.

Dr. Fucinari is a national speaker representing several state associations and speaker bureaus, including NCMIC and Foot Leveler’s. He is Certified Insurance Consultant and Certified Medical Compliance Specialist.

Topics to be discussed will include:

  • Federal and state anti-kickback and fraud and abuse laws
  • Federal and state self-referral laws, including the federal Stark law
  • Restrictions on patient transfers, including the Federal Emergency
  • Medical Treatment and Active Labor Act (EMTALA)
  • National Committee for Quality Assurance (NCQA) Guidelines
  • Gainsharing arrangements
  • Patient consent issues
  • Medicare conditions of participation
  • Federal and state privacy laws, including the Health Insurance
  • Portability and Accountability Act (HIPAA)
  • False Claims Act
  • CLIA Guidelines
  • Code of Conduct and the Qui Tam Policy
  • 1995 and 1997 E/M Guidelines