Wed, Nov. 13, 2013
HHS OIG Releases Advisory Opinion Finding A Company Model Type Arrangement May Violate the Federal Anti-Kickback Statute
Tuesday, November 12, 2013
ASA applauds the U.S. Department of Health and Human Services Office of the Inspector General's (HHS-OIG) release of
Advisory Opinion No. 13-15, which addresses a specific company model-like arrangement in a hospital setting involving anesthesia services and a psychiatry group. The opinion found that the referenced company model-like arrangement, which would allow the referring physician to retain anesthesia revenue, could violate the Federal Anti-Kickback Statute.
Specifically, HHS-OIG found that the proposed arrangement appeared to be designed to permit the referring physician psychiatry group "to do indirectly what it cannot do directly; that is, to receive compensation, in the form of a portion of Requestor's anesthesia services revenues, in return for the Psychiatry Group's referrals of ECT patients to Requestor for anesthesia services." The opinion concluded that the proposed arrangement "could potentially generate prohibited remuneration under the Anti-Kickback Statute and that the OIG could potentially impose administrative sanctions" with the caution that "any definitive conclusion regarding the existence of an anti-kickback violation requires a determination of the parties' intent, which…is beyond the scope of the advisory opinion process."