decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Anti-Kickback Advisory Opinion Summaries / 2006 OIG Advisory Opinions / Opinion 06-02 - DME Supplier-Physician Joint Venture Rejected
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Article Overview
This summary reviews an OIG advisory opinion from 2006 involving a proposed joint venture between a durable medical equipment supplier and physician practices. It explains the general structure of the proposed arrangements, the federal health care fraud and abuse concerns raised by the OIG, and the reasons the proposal was not approved. The article is relevant to compliance staff, health law practitioners, physician practices, and suppliers evaluating joint venture structures involving federally reimbursed and private-pay business.
Why This Topic Matters
It helps readers understand how OIG evaluates supplier-physician business arrangements and why separating federal claims from private-pay business may still leave anti-kickback exposure in certain joint venture structures.
What You Will Learn
- How the proposed joint venture arrangements were structured at a high level
- What types of fraud and abuse concerns the OIG associated with the proposal
- Why physician participation and revenue-sharing arrangements can raise compliance issues
- How the opinion addresses the relationship between private-pay business and federally reimbursed claims
Who Should Read This
- Compliance professionals
- Health care attorneys
- Physician practice administrators
- Durable medical equipment suppliers
- Medical billing and coding professionals
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