Physicians receiving payments as “medical directors,” advisors, consultants etc. have once again raised the hackles of HHS’ regulatory team. In recent communications from HHS to the provider community, HHS once again warned doctors entering into compensation agreements to be mindful of the “anti-kickback” laws. With Medicare, Medicaid and commercial carrier reimbursements decreasing physicians are taking opportunities to become staff members or to provide other advisory or clinical services for a fee.
The admonition warns of “quid pro quo” relationships in which the provider in exchange for money, appears to, or actually provides referral patients to another provider, facility etc..
According to Modern Healthcare “legal experts agree that the alert could signal that the feds plan to increasingly pursue allegations against individual doctors, rather than just the organizations that pay them.” This alert was generated following an agreement to settle recent charges by HHS and 12 individual physicians who entered into “questionable” medical directorships. HHS investigated a Houston imaging center that seemed to be giving compensation to physicians referring patients, resulting in the center and physicians being excluded from doing business for six years with any federal programs.
Physicians should keep in mind that compensation for directorships etc. should be at market levels and should not be associated with increased patient volume, referrals or other services provided. The current environment would suggest that taking such directorship-type positions should be transparent, and “squeaky clean.”
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