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Anti-kickback issue related to physician payment

Compliance Monitor, March 31, 2006

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Q: Our board has decided to compensate orthopedics and neurosurgery panel members who treat patients, including those without insurance, since the physician's represent critical services in the emergency department. Is this okay? Do you see any anti-kickback statute issues?

A:Yes this is okay, provided that these arrangements are memorialized in contracts or service agreements that demonstrate that there is an actual service provided in exchange for this compensation. In so doing, it should be recognized that on-call physicians provide two services, first for the hospital by making themselves available to respond (standby service) and the second for the patient by consulting over the phone or coming in and providing direct care (clinical service). Both of these services could be compensated or supplemented by the hospital; however, work with an experienced healthcare attorney to ensure that hospital drafts these contracts and service agreements appropriately.

Thanks to Joseph Gatewood, Esq., Loren Johnson, MD, FACEP, and Ellen Arrington, RN, BSN, the authors of A Practical Guide to EMTALA Compliance, published by HCPro. Inc. www.hcpro.com.

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