Dive Brief:
- A new alert issued by the HHS Office of Inspector General warns physicians to be cautious about payment agreements that may violate the anti-kickback statute.
- This new alert warns doctors to be careful when entering payment arrangements such as medical directorships that their compensation reflects fair market value of services provided and does not include attracting more referrals.
- This marks the third such alert in three years. The previous alert involved physician-owned device distributorships and lab payments to doctors.
Dive Insight:
The alert included information on OIG settlements with 12 doctors who had "questionable" medical directorship agreements that did not reflect fair market value or in which the physicians failed to provide services in the agreements. These doctors had agreements with the Fairmont Diagnostic Center and Open MRI, both located in Houston.
This latest alert indicates OIG is paying more attention to individual doctors, holding them accountable for payment arrangements. Although most settlement cases are handled via civil court, the alert warned doctors that if the government can prove criminal intent, they could be handled criminally too.
"I think what we're seeing is OIG taking more of an interest in pursuing the physician side of the questions, at least looking at if a physician has some role to play or liability in the conduct," said Tony Maida, a partner at McDermott Will & Emery and a former deputy chief of OIG's Administrative and Civil Remedies Branch.