Hospital payments to physicians for providing emergency department on-call coverage, responding to emergency department calls, or providing inpatient care for uninsured persons could potentially violate anti-kickback statutes, according to an HHS inspector generals office advisory opinion.
The opinion, signed by Lewis Morris, chief counsel to the inspector general, acknowledged that hospitals are increasingly paying physicians for on-call coverage and that HHS is mindful that legitimate reasons exist for such arrangements, such as compliance with the 1986 Emergency Medical Treatment and Active Labor Act or regional scarcity of physicians. But it also states that on-call coverage compensation potentially creates considerable risk that physicians may demand such compensation as a condition of doing business at a hospital.
The opinion was in response to one medical centers request for a legal review of its program, and the name of the facility was deleted from the copy of the opinion made available to the public.
The fact that the institutions on-call compensation arrangement was deemed acceptable is the important factor to consider, said Phil Miller, vice president of communications for physician-recruiting company Merritt, Hawkins & Associates.
The medical center in question will not be penalized because they structured their arrangement properly, Miller said. He explained that the key points in the facilitys favor were: that it had an outside consultant determine what was fair market value; physicians were paid equally regardless of the number of patient referrals they brought to the medical center; there was a demonstrated need to provide compensation in order to obtain physician services; it was demonstrated a service was actually being provided; and it was demonstrated that the community is better off because of the arrangement.
Its quite possible that hospitals can still get in trouble, Miller said, adding that this opinion applies to one institution and is not necessarily precedent-setting. Its the same game and the same rules that weve seen for years. So, dont panicjust know what youre doing. -- by Andis Robeznieks