Medical Necessity – The Case for Checks and Balances

balancing costs and careGreeley CMO Rick Sheff, MD, is joined by attorney Chad Eckhardt of Frost Brown Todd to explore medical necessity. Recent CMS/OIG settlements in the hundreds of millions have hospitals and systems thinking twice about trusting the medical staff’s regular peer review process to identify challenges and take proactive steps if/when self-reporting is warranted and appropriate. Understand what OIG is looking for vs. what medical staffs look for, what self-reporting vs. enforcement settlements look like, and what steps your organization can take to be more compliant and proactive.

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