Question

The Federal Anti-Kickback Statute places certain constraints on business arrangements related directly or indirectly to items or services reimbursed by any Federal health care program, including, but not limited to, Medicare and Medicaid. According to the OIG, which of the following would likely be an acceptable practice?

A. A physician practice should participate in all aspects of a hospital's compliance program to be sure the anti-kickback statute is not violated.
B. The hospital should oversee the physician practice's compliance program at no cost for the physicians in exchange for timely and accurate completion of inpatient records.
C. The physician practice should limit participation in a hospital's compliance program to training and education or policies and procedures only.
D. A hospital performs an annual claim audit for its affiliated physician practices. There is no charge for the audit as the hospital includes this as part of its annual compliance program.

Answer 1

Option A, which suggests full participation of a physician practice in a hospital's compliance program, is likely the acceptable practice under the Federal Anti-Kickback Statute according to the OIG. This approach ensures adherence to regulations by preventing inappropriate financial relations and the consequent overutilization of services.

Step-by-step explanation:

According to the OIG, an acceptable practice under the Federal Anti-Kickback Statute would likely be A. A physician practice should participate in all aspects of a hospital's compliance program to be sure the anti-kickback statute is not violated. This inclusion would ensure that both the hospital and physician practice abide by the regulations intended to prevent inappropriate financial incentives that could influence healthcare service delivery. Participation in a compliance program can be an important part of a provider's efforts to comply with regulations and avoid the risks of incentivized overutilization of services that a fee-for-service model might present.

In contrast, practices such as having a hospital oversee a physician practice's compliance program at no cost (option B), limiting participation to certain aspects of the compliance program (option C), or performing annual claim audits at no charge (option D) could potentially be viewed as providing something of value that might influence referrals or other business generated under Federal health care programs, which could potentially violate the anti-kickback statute.