Physician Compensation Fraud Alert

by  Wyn Staheli, Director of Research
February 23rd, 2017

In June 2015, the Office of Inspector General (OIG) issued a Fraud Alert focused on physicians and compensation arrangements. Providers need to ensure that these arrangements do not violate the Anti-Kickback Statute. Healthcare providers found to have committed fraud are subject to possible criminal, civil and administrative sanctions. 

In this alert it states that the "OIG encourages physicians to carefully consider the terms and conditions of medical directorships and other compensation arrangements before entering into them."

The key thing to remember is "fair-market value" for services rendered by the provider. Several recent settlements demonstrate what the OIG considers to be inappropriate arrangements:

The OIG has also issued a "Roadmap to Avoiding Medicare Fraud and Abuse" to help providers discover other potential problems. This document includes the following Stark violation settlements:

QUESTION CHECKLIST

Before entering into any arrangement, ask the following questions to avoid potential pit-falls. If you answer yes to any of them, it is potentially fraudulent:

References:

Physician Compensation Fraud Alert. (2017, February 23). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/physician-compensation-fraud-alert-29964.html

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