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O C T O B E R 2 0 1 5 | O U T P A T I E N TS U R G E R Y. N E T
for bona fide services the physicians actually provide," reads the alert,
which was issued in June. So if it's been a while since you examined
how you're paying your medical director, now might be a good time to
do so to make sure the arrangement is above board.
Questionable quid pro quo
The alert was triggered by the OIG's recent settlements with 12 physi-
cians who had entered into "questionable medical directorship and
office staff arrangements." The OIG alleged the arrangements repre-
sented improper remuneration under the federal Anti-Kickback
Statute because:
• the payments to the physicians took the volume or value of patient
referrals into account and did not reflect fair market value for the
services to be performed, and
• the physicians did not provide the services required under the
arrangements.
The OIG further alleged that, in some of the arrangements, the
healthcare facility or system with which the physicians were affiliated
paid their office staffs' salaries, which was seen as a violation as it
"relieved the physicians of a financial burden they otherwise would
have incurred."
While the OIG determined that "the physicians were an integral part
of the scheme and subject to liability under the Civil Monetary
Penalties Law," its future investigations and sanctions are likely to
hold facilities that hire medical directors or enter into other compen-
sation arrangements with physicians liable if warranted.
Drawing the line
In light of the recent alert, surgical facilities and their member physi-
cians are strongly advised to review all existing and future medical