The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently released a fraud alert urging physicians to evaluate the terms and conditions of compensation arrangements, to ensure that they reflect fair market value for bona fide services actually provided. Physicians are reminded by the OIG that an arrangement can violate the Anti-Kickback Statute (AKS) if even one of its purposes is compensation based on past or future referrals of federal health care program business.
The fraud alert was prompted by recent OIG settlements with 12 physicians engaging in questionable medical directorship and office staff arrangements. The OIG contended the arrangements constituted improper remuneration under the AKS for the following reasons: (1) physician payments took into account the volume or value of referrals; (2) physician payments did not reflect fair market value for the services performed; and (3) physicians did not actually provide the services listed under the agreements.
The OIG Fraud Alert is available at:
Department of Health and Human Services Office of Inspector General. “Fraud Alert: Physician Compensation Arrangements May Result in Significant Liability.” 9 Jun. 2015.