HHS inspector generals office published an advisory opinion finding that a proposed joint venture between a cancer treatment facility and several urologist groups would violate the anti-kickback statute.
Under the deal, a physicians group that owns a cancer treatment center would enter leases with several urologist groups in the area for examination and treatment rooms, along with equipment and personnel services, to perform intensity modulated radiation treatment for prostate cancer. The facilitys physicians, acting as independent contractors, would supervise the treatments. The urologist groups would bill Medicare for the professional and technical components, benefiting from the difference between the payment and their costs for the lease and fees.
The inspector generals office concluded the arrangement could be a means for the center to do indirectly what it cannot do directly: that is, pay the urologist groups a share of the profits from their IMRT referrals.
The arrangement includes several features described as typical of suspect contractual joint ventures in a 2003 bulletin, the inspector generals office concluded.
The urologist groups would be in a position to ensure the success of the business, not only by referring to the requesters facility for IMRT, but by the choice of IMRT over other available therapies for prostate cancer.
Finally, the opinion notes that it wouldnt matter whether the written agreements could satisfy safe harbors the government has carved out for the anti-kickback statute, applying only to the money flowing to the center and leaving the income collected by the urologist groups potentially in violation of the law. -- by Gregg Blesch