Medical Billing Blog

Special Fraud Alert: Laboratory Payments to Referring Physicians

Posted by Scott Shatzman on Tue, Jul, 08, 2014 @ 08:07 AM

cartoon6255The HHS OIG released a Special Fraud Alert addressing compensation paid by laboratories to referring physicians and physician group practices (collectively, physicians) for blood specimen collection, processing and packaging, and for submitting patient data to a registry or database.

 

This is the most recent of a series of guidance documents and advisory opinions addressing the general subject of remuneration offered and paid by laboratories to referring physicians

 

In these and other documents, OIG has emphasized that providing free or below-market goods or services to a physician who is a source of referrals, or paying such a physician more than fair market value for his or her services, could constitute illegal remuneration under the anti-kickback statute.

 

This Special Fraud Alert supplements these prior guidance documents and advisory opinions and describes two specific trends that OIG has identified involving transfers of value from laboratories to physicians that they believe present a substantial risk of fraud and abuse under the anti-kickback statute.