Browse Advisory Opinions

Favorable opinion regarding an orthopedic surgery provider’s proposed warranty program pursuant to which the orthopedic surgery provider would refund certain concierge fees to patients who require revision surgery within 2 years of an initial surgery.

Favorable opinion regarding a proposal by a manufacturer of a clinical laboratory test for colorectal cancer screening to waive any applicable cost sharing for certain commercially insured patients who receive its colorectal cancer screening test.

Favorable opinion regarding a proposed arrangement pursuant to which a medical device manufacturer would offer up to $2,500 to reimburse purchasers for actual costs incurred associated with a needle stick injury caused by the failure of a device that it manufactures.

Favorable opinion regarding an arrangement whereby Requestor— designated as a community health center pursuant to Section 330 of the Public Health Service Act—proposes, during the provision of certain social services to individuals, to: (1) identify individuals in need of primary care services; (2) inform them of the availability of such services; and (3) schedule an appointment for them to receive primary care services from Requestor or refer them to a local primary care provider.

Favorable opinion regarding: (i) a limited-time program to refund, waive, or delay requiring receipt of payment for a drug in the event of an insurance reimbursement denial or delay; and (ii) certain discounts to the cost of the drug.

Favorable opinion regarding a one-time, voluntary redemption offer to physician partners reaching age 67 to have their partnership units repurchased by a partnership over a 2-year period, contingent upon the physician partners’ agreement to retire from the practice of medicine.

Unfavorable opinion regarding a cochlear implant manufacturer’s proposal to offer and provide a free compatible hearing aid to certain patients, including Federal health care program beneficiaries, who receive one of the cochlear implants it manufactures.

Favorable opinion regarding a proposal to provide a prepaid card to certain individuals, including Federal health care program beneficiaries, to encourage those individuals to return the sample collection kit associated with a colorectal cancer screening test.

Regarding Requestors’ proposal to pay salaries to, and nurse aide certification program tuition costs on behalf of, new employees who Requestors have hired to work as certified nurse aides for Requestors’ home health agencies.

Regarding a pain management company’s proposal to retain net profits from services provided by an employed certified registered nurse anesthetist pursuant to a reassignment of billing rights.

Regarding a pharmaceutical manufacturer's proposal to loan, on a temporary basis, a limited- functionality smartphone to financially needy patients who do not have the technology necessary to receive adherence data from a sensor embedded in prescribed antipsychotic medication.

Regarding a pharmaceutical manufacturer's proposal to replace products that require specialized handling that could not be administered to patients for certain reasons, at no additional charge to the purchaser.

Regarding a hospital outpatient facility's proposal to reduce or waive, on a non-routine, unadvertised basis, cost-sharing amounts owed by financially needy Medicare beneficiaries for items and services furnished in connection with a clinical research study.

Concerning a fire protection district's policy of billing only individuals who reside outside the fire protection district for emergency medical services.

Concerning an exclusive contract for emergency medical services and transports between a municipality and an ambulance company. The opinion addresses the aspect of the contract that requires the ambulance company to reimburse the municipality for a portion of the costs of providing emergency dispatch services.

Concerning a Federally qualified health center's proposal to offer grocery store gift cards to certain patients in capitated managed care plans as an incentive to receive health screenings or other clinical services.

Concerning a proposal for an independent diagnostic testing facility to hire a doctor to read and interpret test results when that doctor is closely related to the owners of the independent diagnostic testing facility and is employed by a company that also employs other potential referral sources.

Concerning an online referral service whereby post-acute care providers would pay a fee to electronically receive and respond to referral requests from hospitals for post-discharge care.

Concerning a radiology group's proposal to offer free insurance pre-authorization services to referring physicians.

Concerning a proposed arrangement for a non-profit charitable organization to receive donations of cash and durable medical equipment ("DME") from pharmaceutical manufacturers, DME suppliers and others, to provide funding grants and DME to entities that serve individuals suffering from coagulation disorders, and to provide DME directly to certain financially needy individuals.