New OIG Advisory Opinion Addresses Hospital On-Call Payments to Specialty Physicians


[author: ]

Yesterday, the OIG released Advisory Opinion No. 12-15 addressing whether a hospital's per diem payment to specialty physicians for call coverage violated the Anti-Kickback Statute. Ultimately the OIG determined the proposed on-call arrangement did not violate the Anti-Kickback Statute.

Factors important to its analysis included (i) the per diem payments were set in advance for each specialty and offered to each physician on staff within the specialty regardless of the volume or value of their referrals; (ii) the physicians were providing actual and necessary services for which they might not otherwise be compensated; and (iii) the hospital certified it absorbs all costs associated with the on-call program and no cost accrues to Federal government health care programs.

Although the advisory opinion does not address compliance with the Stark law, it is a helpful read for hospitals and their advisors paying for call coverage or physician groups receiving payment for call coverage. A copy of the Advisory Opinion can be accessed here.