Medicare Compliance & Reimbursement

What is it: If you think one of your practice's actions might be in violation of the law (such as the civil monetary penalties or Stark laws), you can ask the OIG to analyze your case and make a determination regarding the legality of your arrangement.

What it doesn't cover: The OIG will not address topics such as "model arrangements" or general questions of interpretation, among other issues, in advisory opinions.

How to request one: If you'd like to ask the OIG to issue an advisory opinion on your situation, you should gather the required materials (including two copies of your request, your contact information, and an initial $250 fee) and submit them to the OIG. (View a full list at www.oig.hhs.gov/fraud/advisoryopinions/aofaq.asp.)

Prep your documents: Before you create your advisory opinion request, you should consider asking a health care attorney for advice, says Mark Rogers, Esq. with The Rogers Law Firm in Boston. "The attorney should be able to provide an opinion as to whether the arrangement creates any potential fraud and abuse liability exposure for the parties involved in the arrangement," Rogers says. Your attorney can spot whether an Advisory Request is appropriate and help you prepare your documentation.

Request before implementing: If you think your practice would benefit from an Advisory Opinion, file your request before you begin performing the questionable action. "The advisory opinion process is designed to yield reviews of proposed arrangements," says David C. Harlow, Esq. with The Harlow Group in Newton, Mass.