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Advisory Opinions

HHS-OIG issues advisory opinions about the application of certain fraud and abuse enforcement authorities to the requesting party’s existing or proposed business arrangements.

Recent Activity

  • AO 22-22 was posted on December 28, 2022

    Regarding a pharmaceutical manufacturer’s proposal to provide up to a specified number of trial units of a long-acting antipsychotic drug to certain hospitals for inpatient use.

  • AO 22-21 was posted on December 23, 2022

    Regarding an arrangement in which a county and its department of public health’s emergency medical services division sublease certain space and lease certain furniture and equipment to a private ambulance company that has been granted an exclusive contract for the provision of emergency ambulance transports in certain parts of the county.

  • AO 22-20 was posted on December 19, 2022

    Regarding a hospital’s utilization of its employed nurse practitioners to perform services that traditionally have been performed by a patient’s attending physician in certain medical units.

  • AO 22-19 was posted on October 5, 2022

    Regarding a proposal whereby certain pharmaceutical manufacturers would: (i) fund, through Requestor, cost-sharing subsidies for the manufacturers’ Part D oncology drugs; (ii) fund, through Requestor, specified programs and eligible beneficiaries’ health insurance premiums; and (iii) finance Requestor’s operating costs.

  • AO 22-18 was posted on September 20, 2022

    Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.

  • AO 22-17 was posted on September 6, 2022

    Regarding a proposed restructuring of financial relationships, which includes the forgiveness of debt, between a health system and a nearby clinic.

  • AO 22-16 was posted on August 19, 2022

    Regarding the provision of a gift card to certain Medicare Advantage plan enrollees who complete specific steps in an online patient education program.

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