Health Law Checkup - November 2009
Recent HHS OIG Opinions Permit Certain Hospital and Physician Group Joint Ventures
The Department of Health and Human Services Office of Inspector General (OIG) recently issued several advisory opinions that clear the way for certain ambulatory surgical center joint ventures and "gainsharing" arrangements between hospitals and physician groups. Although the OIG continues to note its longstanding concerns about arrangements between potential referral sources and those furnishing items or services payable by federal healthcare programs, OIG found the structure of the following arrangements posed a low risk of fraud and abuse. Therefore, the proposed ambulatory surgical center joint venture would not trigger sanctions under the federal anti-kickback statute and the proposed gainsharing arrangement would not trigger sanctions under either the anti-kickback statute or under Sections 1128A(b)(1) and (2) of the Social Security Act.