Home Health & Hospice Week

Be careful if you are a CPAP supplier with ties to Independent Diagnostic Testing Facilities. In a new advisory opinion, the HHS Office of Inspector General warns that a submitted supplier- IDTF relationship is full of potential for kickback violations. Under the arrangement, the CPAP supplier pays the IDTF for a package of services which may include setting up the CPAP and educating the non-Medicare or Medicaid patient about it and maintaining the CPAP equipment under consignment. The IDTFs may be owned by physician prescribing the CPAPs.

Excluding beneficiaries insured by federal health care programs doesn't fix the kickback problems, the OIG notes. "IDTFs participating in the Existing Arrangement may still influence referrals of Federal health care program beneficiaries to the Requestor for DME," the opinion points out.

The arrangement doesn't qualify for a safe harbor. And the IDTF staff and owner physicians can influence the patient's choice of supplier. "Arrangements that closely tie DME suppliers to IDTF staff members, physicians with financial interests in the IDTFs who are in a position to prescribe, and patients ... are particularly susceptible to problematic marketing schemes," the OIG wanrs. Such "white coat" marketing could unduly influence susceptible patients.

The advisory opinion is at http://oig.hhs.gov/fraud/docs/advisoryopinions/2011/AdvOpn11-08.pdf.