On Aug. 31, the HHS Office of Inspector General released an Advisory Opinion regarding the provision of free pre-authorization services by a hospital for diagnostic imaging services provided by the hospital.
An undisclosed hospital requested the opinion in response to its proposal to provide pre-authorization services free of charge to physicians and patients for diagnostic imaging services. The hospital asserted that many insurers now require pre-authorization for diagnostic imaging, and the hospital desired to provide this service at no cost to all physicians and patients without regard to the physician's volume or value of business.
Based on the facts certified in the request, the OIG concluded that while the proposed arrangement could potentially generate prohibited remuneration under the anti-kickback statute, if the requisite intent to induce or reward referrals of federal healthcare program business were present, the OIG would not impose administrative sanctions in connection with the proposed arrangement. The OIG listed several reasons for its decision, one of which was that the proposal included safeguards to lower the risk of fraud.
Read the full OIG Advisory Opinion.
An undisclosed hospital requested the opinion in response to its proposal to provide pre-authorization services free of charge to physicians and patients for diagnostic imaging services. The hospital asserted that many insurers now require pre-authorization for diagnostic imaging, and the hospital desired to provide this service at no cost to all physicians and patients without regard to the physician's volume or value of business.
Based on the facts certified in the request, the OIG concluded that while the proposed arrangement could potentially generate prohibited remuneration under the anti-kickback statute, if the requisite intent to induce or reward referrals of federal healthcare program business were present, the OIG would not impose administrative sanctions in connection with the proposed arrangement. The OIG listed several reasons for its decision, one of which was that the proposal included safeguards to lower the risk of fraud.
Read the full OIG Advisory Opinion.