Browse Advisory Opinions

Concerning a substance abuse treatment center's use of motivational incentives to reward a patient's achievement of certain treatment-related goals.

Concerning a hospital's proposed donation of a medical office building to a state-affiliated medical school that will use the building to relocate the school's existing family medicine clinic.

Concerning a proposal by a municipal corporation that provides emergency medical services (EMS) through its fire department to treat revenue received from certain local taxes as payment of otherwise applicable cost-sharing amounts due from residents and nonresident taxpayers who receive EMS within the municipality.

Concerning a municipality that owns and operates an ambulance service and that proposes to treat revenue received from local income taxes as payment of otherwise applicable cost-sharing amounts due from taxpayers who receive ambulance services within the municipality.

Concerning a municipal corporation that is proposing to reduce its fees for ambulance services for residents by an amount consistent with their cost-sharing obligations.

Concerning a proposal to reintegrate a medical group and a hospital that were originally a single entity and whether the proposed arrangement would violate the anti-kickback statute.

Concerning a payment arrangement between a Medicare-certified hospice and certain nursing facilities for services provided to residents of such facilities who are eligible both for Medicaid and Medicare hospice benefits ("Dually Eligibles"). Specifically, for Dually Eligibles, the hospice pays the nursing facilities the full Medicaid nursing facility per diem rate for non-hospice patients, which covers pharmacy services, plus a separate payment for drugs used by Dually Eligibles in connection with their terminal illness. You have asked whether such an arrangement would constitute grounds for the imposition of sanctions under the exclusion authority at section 1128(b)(7) of the Social Security Act (the "Act") or the civil monetary penalty provision at section 1128A(a)(7) of the Act, as those sections relate to the commission of acts described in section 1128B(b) of the Act.

Concerning "a proposed arrangement between a hospital and a new physician whom the hospital would like to recruit to practice within its service area."

Whether certain arrangements for discounted ambulance services provided to residents of Medicare skilled nursing facilities would result in prohibited remuneration and sanctions under the anti-kickback statute.