OIG gives OK to call panel plan
In a recently released advisory opinion, the Health and Human Services' Office of Inspector General (OIG) has told the facility that requested the opinion, which they didn't disclose, that its plan to compensate physicians for taking call represented "a low risk of fraud and abuse."
The problem with this and all such OIG opinions is that the office makes it very clear that the opinion applies very specifically to the facility in question, and even then is valid only if the facts represented by the facility are all accurate.
"This a nonprofit facility, the only provider in its county that provides inpatient acute care services," notes Robert A. Bitterman, MD, JD, FACEP, president of Bitterman Health Law Consulting Group, in Harbor Springs, MI. "It provides a disproportionate amount of care for the indigent and had acute gaps in services because doctors no longer voluntarily took call."
The compensation plan is as follows:
- Emergency consultations on an eligible patient presenting: $100 flat fee.
- Care of eligible patients admitted as inpatients from the emergency department (the admission to physician's service must be while physician is on call for the requestor's ED, and includes inpatient care and management, history and physical, daily rounds, discharge summary, etc.): $300 per admission.
- Surgical procedure or procedures performed on an eligible patient admitted from the emergency department: $350 flat fee for the primary surgeon of record.
- Endoscopy procedure or procedures performed on an eligible patient admitted from the emergency department: $150 flat fee for the physician performing the endoscopic procedure.
Any time you pay physicians to be on call, it has the potential for fraud and abuse because it could be disguised as what OIG calls an 'unlawful remuneration,' or doctors might demand compensation as a condition of doing business at a hospital, Bitterman notes. "That's why it will always be scrutinized," he says.
Finally, says Bitterman, the OIG always cautions in these opinions that they should not be construed as a requirement for hospitals to pay physicians to take call. (Editor's note: The opinion may be found at www.oig.hhs.gov/fraud.)
In a recently released advisory opinion, the Health and Human Services' Office of Inspector General (OIG) has told the facility that requested the opinion, which they didn't disclose, that its plan to compensate physicians for taking call represented "a low risk of fraud and abuse."You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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