Medicare Compliance & Reimbursement

At the behest of the American Medical Association, the HHS Office of Inspector General is looking into possible kickback implications in the way hospitals grant and withhold staff privileges to physicians. But hospitals maintain that counting privileges as a payment that could amount to a kickback would open a Pandora’s Box of compliance burdens and Stark law disasters.

In February correspondence with IG Janet Rehnquist, the American Hospital Association and the Federation of American Hospitals both maintain that the anti-kickback law has no bearing on staff privileges — and that interjecting the feds into credentialing decisions designed to assure quality patient care is a big mistake.

Moreover, the AHA claims that if the OIG deems staff privileges “remuneration” under the antikickback law, the legal implications would be devastating.

“Such an approach would immediately put every hospital and physician in violation of the Stark law, as well as create significant compliance burdens under the tax laws,” AHA Executive Vice President Rick Pollack

Both groups urge the OIG — which didn’t seem utterly convinced of the application of the anti-kickback law to staff privileges issue in its request for comments — to refrain from issuing new regulations on the matter.