Healthcare

RECENT DEVELOPMENT IN HEALTH CARE LAW


OIG Advisory Opinion No. 02-7. On June 12, the Office of Inspector General published the enclosed Advisory Opinion. The Advisory Opinion was requested by an entity that provides portable x-ray and other mobile diagnostic services. The requestor proposed waiving coinsurance for portable x-ray services provided to nursing facility residents who are eligible for Medicare and Medicaid but who do not meet the eligibility requirements for Qualified Medical Beneficiaries (Medicare patients who also receive assistance from Medicaid by way of payment of Medicare Part B premiums, deductibles and co-payments). The OIG concluded that the proposed waiver could potentially generate prohibited remuneration under the anti-kickback statute and that the OIG could potentially impose administrative sanctions in connection with the proposed waiver. The OIG went on to indicate that any definitive conclusion regarding the existence of an anti-kickback violation would require a determination of the parties’ intent, which determination was beyond the scope of the advisory opinion process.

June 20, 2002

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