decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Anti-Kickback Advisory Opinion Summaries / 2007 OIG Advisory Opinions / Opinion 07-10 - Payments For On-Call Coverage Permitted Under Certain Circumstances
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Article Overview
This premium summary explains an OIG advisory opinion involving a nonprofit hospital’s arrangement with physicians for on-call coverage and indigent care services. It is relevant to hospitals, physicians, compliance staff, and coding or reimbursement professionals who need to understand the fraud-and-abuse compliance context and related Stark Law considerations. The article focuses on the structure of the arrangement, the factors the OIG considered, and the broader compliance implications for similar physician coverage arrangements.
Why This Topic Matters
Hospitals and physician organizations often need to structure coverage arrangements carefully to reduce fraud-and-abuse risk. This article helps readers understand the compliance issues highlighted by the OIG and why similar payment arrangements may require review under both anti-kickback and Stark frameworks.
What You Will Learn
- What the OIG advisory opinion addressed
- Why on-call coverage arrangements can raise compliance concerns
- What broad factors were discussed in evaluating the arrangement
- How the opinion relates to hospital physician coverage practices
- Why related Stark Law issues may also matter
Who Should Read This
- Hospitals
- Physicians
- Compliance officers
- Health care attorneys
- Revenue cycle and reimbursement professionals
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