OIG warns physicians of fraud over compensation packages

Based on recent settlements with 12 physicians over violations of the anti-kickback statute, the Office of the Inspector General is urging physicians who enter into medical directorships to ensure the arrangements reflect fair market value for services.

Based on recent settlements with 12 physicians over violations of the anti-kickback statute, the Office of the Inspector General is urging physicians who enter into medical directorships to ensure the arrangements reflect fair market value for services.

A compensation arrangement may violate the anti-kickback statute if even one purpose of the arrangement is to compensate a physician for his or her past or future referrals of federal health care program business, according to the OIG.

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The OIG did not name the 12 physicians with whom it settled, but said the pay the physicians received was improper for a number of reasons. For starters, the medical directorship arrangements included payments that took into account the physicians’ volume or value of referrals and did not reflect fair market value for the services to be performed, according to the OIG. Also, the physicians allegedly did not actually provide the services called for under the agreements.

OIG also alleged that some of the 12 physicians had entered into arrangements under which an affiliated health care entity paid the salaries of the physicians’ front office staff. Because these arrangements relieved the physicians of a financial burden they should have shouldered, OIG alleged the salaries were improper.

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OIG said physicians to carefully consider the terms and conditions of medical directorships and other compensation arrangements before entering into them.

Those who commit fraud involving federal health care programs are subject to possible criminal, civil, and administrative sanctions, the OIG stated.

Twitter: @SusanMorseHFN