Category Archives: OIG Advisory Opinions

OIG Advisory Opinion 12-22 – No Sanctions Imposed For Hospital’s Bonus Payments to Physician Group

On December 31, 2012, the OIG issued a favorable Advisory Opinion, No. 12-22, concerning a cardiology co-management agreement between a hospital and a private cardiology group practice (the “Management Agreement”).  Although the  Management Agreement potentially implicates the Anti-Kickback Statute and includes bonuses provided to a physicians’ group in exchange for implementing quality-improvement and cost-saving measures at the hospital’s cardiac catheterization laboratories (the “Arrangement”), the OIG advised that it would not impose sanctions on the requesting parties under the Civil Monetary Penalty or the Anti-Kickback Statute.  Continue reading

OIG: OKs Volunteer Provided Care to Terminally Ill Patients Before Hospice Eligibility

The Department of Health and Human Services’ Office of Inspector General (“OIG”) recently issued advisory opinion 12-17 providing a favorable opinion on a not-for-profit hospital-based hospice’s proposed “community services” program.

The Community Services Program

Under the proposed program, the hospice planned to provide non-skilled services for free, to patients who were terminally ill but who did not qualify for the hospice benefit, because they either did not want to renounce curative treatment or because they had more than six months to live if the disease ran its normal course. The services the agency proposed to offer included companionship, visitation, transportation, running errands, food preparation, respite and assistance with reading and writing. The hospice specifically stated that it would not offer these services to patients that resided in nursing facilities. Continue reading

OIG: Proposed Arrangement Between Physician and IDTF Does Not Violate the Anti-Kickback Statute

On June 29, 2012, the OIG issued a favorable Advisory Opinion, No. 12-08, concerning a proposal for an independent diagnostic testing facility (the “IDTF”) to hire a physician (the “Physician”) to read and interpret sleep test studies when the Physician is closely related to the majority owners of the IDTF and is further employed by a company that also employs other potential referral sources (the “Proposed Arrangement”). Continue reading

OIG: Proposed Arrangements Between Anesthesiology Group and ASC Might Violate Anti-kickback Statute

On June 1, 2012, the Department of Health and Human Services Office of Inspector General (the “OIG”) issued Advisory Opinion No. 12-06, warning that two proposed arrangements between an anesthesiology practice (the “practice”) and one or more physician-owned ambulatory surgical centers (the “ASCs”) could potentially violate the Anti-kickback Statute (the “AKS”).  The anesthesiology practice requested the Advisory Opinion because it is purportedly under pressure to enter into one of the proposed arrangements by several ASCs for which it is the exclusive provider of anesthesia services in order to retain such business relationships. Continue reading

Summary of OIG Advisory Opinion 11-18

On November 30, 2011, the OIG issued a favorable Advisory Opinion, No. 11-18, concerning a proposed arrangement that would facilitate the electronic exchange of information between health care practitioners, providers, and suppliers (the “Proposed Arrangement”).  Although, the Proposed Arrangement potentially implicates the Anti-Kickback Statute and includes a per-click fee arrangement, the OIG advised that it would not subject the data management company (the “Requestor”) to administrative sanctions under the Anti-Kickback Statute. Continue reading

OIG Advisory Opinion No. 11-17 – Physician – Lab Arrangement Could be an AKS Issue

On November 23, 2011, the OIG issued Advisory Opinion No. 11-17, which concluded that a proposed arrangement between primary care physicians (the “Physicians”) and a laboratory management company (the “Lab Company”) could potentially generate prohibited remuneration under the Anti-Kickback Statute. Continue reading

OIG Advisory Opinion 11-16 – Hospital’s Provision of Transportation, Lodging, and Meal Assistance to Patients and their Family is OK

On November 15, 2011, the OIG released Advisory Opinion 11-16. In this new advisory opinion, the OIG reviewed a non-profit Hospital’s domiciliary services program that provides transportation, lodging, and meal assistance to certain patients and their family members.  The OIG issued a favorable opinion of the arrangement and concluded that (i) the Arrangement does not constitute grounds for the imposition of civil monetary penalties; and (ii) while the Arrangement could potentially generate prohibited remuneration under the Anti-Kickback Statute, the OIG will not impose administrative sanctions. Continue reading