Medicare Compliance & Reimbursement

Compliance Tip:

High Hospital Physician Salaries Can Trigger Anti-Kickback Concerns

Find out what could put you in jeopardy.

If you think hospital physician compensation that exceeds fair market value can only trigger Stark concerns, beware.

What is true: The anti-kickback law has a safe harbor for employment relationships that doesn't require fair market review, says attorney Wayne J. Miller, with the Compliance Law Group in Los Angeles. Yet if physician compensation is sufficiently "out of whack with national or regional standards," the government can assert that the employment relationship is "actually a sham" used to induce referrals.

Lisa Ohrin, JD, in private practice in Washington, D.C., also urges caution. Physicians who accept an offer that "dramatically" exceeds what they are currently making -- "especially if it's moving into the 70th percentile or above" -- may get in trouble under the antikickback statute, she cautions.

And "the [Health & Human Services Office of Inspector General] can go after both parties (hospital and physician) for anti-kickback violations," Ohrin reminds.