Corporate Compliance

Tip: Avoid anti-kickback statues from exclusive contracts

Compliance Monitor, October 7, 2009

According to the Supplemental Compliance Program Guidance for Hospitals (Supplemental Guidance), the OIG understands the importance of exclusive contracts with a physician or physician’s group. But be warned that these exclusive arrangements may affect the value of the overall arrangement. To avoid an anti-kickback statute violation, the exclusive arrangement must require a hospital-based physician or physician’s group perform reasonable administrative or limited clinical duties directly related to hospital-based professional services at no (or reduced) charge.

All arrangements must be consistent with fair market value and conducted in an arm’s-length transaction; taking into account the value attributable to the exclusivity. Some examples, without limitation, directly related to administrative or clinical duties include:
  • Participation on hospital committees, tumor boards, or similar hospital entities
  • Participation in on-call rotation
  • Performances of quality-assurance and oversight activities
This tip was adapted from The Compliance Program Effectiveness Handbook. For more information about this book, visit the HCMarketplace.

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