OIG Advisory Opinion: Anesthesia Services Arrangements Could Trigger Sanctions
June 15, 2012 | Strategic Insights for Ambulatory Care
After reviewing two proposed arrangements between an anesthesia services provider and several ambulatory surgical centers, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) has determined that the arrangements could potentially generate prohibited remuneration under the antikickback statute and that it could impose administrative sanctions on the provider, according to a May 25, 2012, OIG advisory opinion. In the first proposed arrangement, the anesthesia services provider would serve as the exclusive provider of anesthesia services to the ambulatory surgical centers and pay the centers a per-patient fee, excluding federal healthcare program patients, for providing certain management services, such as preoperative nursing assessments and assistance with billing documentation. OIG explains that although the centers would charge the provider management services fees only with respect to patients who are not beneficiaries of a federal healthcare program, the provider would serve as the exclusive provider of anesthesia services for all of the centers’ patients, including federal healthcare program beneficiaries, so a risk that the provider’s payments might induce referrals still remains.