decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Anti-Kickback Advisory Opinion Summaries / 1998 OIG Advisory Opinions / Opinion 98-04 - OIG Nixes Percentage-Based Management Contracts
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Article Overview
This summary article reviews an OIG advisory opinion involving a physician-owned practice and a management company arrangement in the context of the Anti-Kickback Statute. It is useful for physicians, practice managers, compliance staff, and healthcare attorneys who want a high-level understanding of why certain compensation and referral structures drew OIG concern. The discussion focuses on broad risk areas such as referrals, billing oversight, and utilization concerns rather than on coding guidance.
Why This Topic Matters
It helps readers understand why certain physician-management arrangements can create compliance risk and how OIG analyzed the structure at a policy level.
What You Will Learn
- The general compliance issues raised by percentage-based management arrangements.
- Why referral, billing, and utilization concerns matter in an OIG advisory opinion context.
- How an advisory opinion can inform healthcare compliance review without providing a safe harbor.
- The role of the Anti-Kickback Statute in evaluating physician-management contracts.
Who Should Read This
- Physicians
- Practice administrators
- Healthcare compliance professionals
- Healthcare attorneys
- Medical billing managers
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