decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Anti-Kickback Advisory Opinion Summaries / 1998 OIG Advisory Opinions / Opinion 98-12 - OIG Blesses ASC Joint Venture With Surgeons, Anesthesiologists
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Article Overview
This summary reviews a 1998 OIG advisory opinion addressing an ambulatory surgery center joint venture involving orthopedic surgeons and anesthesiologists. It explains the general compliance context, the concerns the agency has historically raised about joint ventures and referrals, and the types of factors OIG considered in its analysis. The article is relevant to compliance, health care legal, and coding/billing professionals who follow fraud-and-abuse guidance affecting physician investment arrangements.
Why This Topic Matters
Advisory opinions like this help stakeholders understand how OIG evaluates physician-owned facility arrangements under anti-kickback principles. The article is useful for organizations assessing ASC investment structures, referral relationships, and related compliance risk.
Article Sections
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Opinion 98-12 Overview
Introduces the advisory opinion and the health care arrangement under review.
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Joint Venture Background and OIG Concerns
Summarizes the broader fraud-and-abuse context and the agency’s general concerns about physician joint ventures.
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Factors Considered in the Analysis
Describes the categories of circumstances and financial characteristics discussed in the opinion.
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Prior Safe Harbor Discussion
Notes the article’s reference to earlier regulatory activity relevant to similar arrangements.
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Overutilization Considerations
Covers the discussion of utilization risk as part of the agency’s reasoning.
What You Will Learn
- The compliance issues discussed in an OIG advisory opinion about an ASC joint venture
- How physician investment arrangements are evaluated in a fraud-and-abuse context
- The general types of factors that can influence OIG analysis of referral-related risk
- How prior regulatory proposals are referenced in advisory opinion summaries
Who Should Read This
- Compliance officers
- Health care attorneys
- Revenue cycle professionals
- Physician practice administrators
- Ambulatory surgery center administrators
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