The Health and Human Services’ Office of Inspector General (OIG) published an advisory opinion addressing whether the anti-kickback statute may be triggered when a hospital pays a per diem fee to physicians for providing on-call hospital emergency department coverage. The OIG concluded that the arrangement in question presented a low risk of fraud and abuse and would not give rise to administrative sanctions due to a variety of factors outlined in the summary. The OIG also outlined compensation structures to avoid when developing an on-call coverage arrangement.
The on call arrangement was developed in response to shortages experienced by the hospital in neurology and neurosurgery specialties. The OIG confirmed that neurology is included in the on call arrangement.
The OIG determined that the on call arrangement does not violate the anti-kickback statute for the following reasons:
It is important to note that compensation within the on call arrangement varies by specialty and is based on three factors:
The AAN supports the OIG’s advisory opinion and has long believed that patients and communities will have better access to emergency neurologist services for stroke and other illnesses when neurologists are reimbursed to be on call.
Disclaimer: The opinions expressed in this posting are those of the author only and do not represent the views of the American Academy of Neurology or any of its affiliated subsidiaries.
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