On June 9, 2015, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a Fraud Alert focused on compensation arrangements paid to physicians. See, “Physician Compensation Arrangements May Result in Significant Liability” [link:https://oig.hhs.gov/compliance/alerts/guidance/Fraud_Alert_Physician_Compensation_06092015.pdf]. The Fraud Alert focuses on all of the compensation arrangements that may be entered into by and between physicians and health care institutions and brings specific attention to the liability faced by physicians who enter into arrangements that violate the federal Anti-Kickback Statute.
In the Fraud Alert, the OIG brings specific attention to 12 recent settlements with physicians, whose medical director and office staff compensation arrangements, the OIG alleged, were in violation of the antikickback statute. The general items of attention include:
- compensation arrangements that allegedly took into consideration the volume or value of the physician’s referrals and were not fair market value;
- arrangements that allegedly included compensation for services never rendered;
- improper remuneration that allegedly included the reimbursement for a physician’s private practice overhead.