GAO: Consultants Point Docs Toward Federal Law Violations


The General Accounting Office has found that some health care consultants have been advising physicians to do things that conflict with federal laws and that may be unethical. GAO investigators attended and tape-recorded two consultants' workshops. One told doctors not to report Medicare overpayments; the other told a physician to give preferential treatment to patients who have higher-paying insurance plans. Consultants also told physicians to work their prime appointment slots around those who pay the most, thus limiting the time available for Medicare and Medicaid patients.

Several consultants are being prosecuted for advising clients to follow illegal billing practices. The Office of the Inspector General has issued an advisory bulletin to warn providers that hiring a consultant does not shield them in cases of wrongdoing. It reminds physicians to be wary of consultants who make claims that appear too good to be true.

Career Opportunities

HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

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