Browse Advisory Opinions

Concerning a lifestyle modification program for individuals with chronic disease that uses physicians to monitor and evaluate the program's participants.

About a proposed cost-savings program pursuant to which (the Hospital) would reward its non-physician employees for submitting cost-savings suggestions.

Concerning an arrangement to provide various services free of charge to patients with terminal illnesses.

Concerning a consulting firm's contractual payment arrangements for the performance of auditing services to identify hospital undercharges and overcharges associated with private payors.

Regarding rural telemedicine network arrangement implemented and operated pursuant to Federal grants.

Regarding certain arrangements for discounted pathology services provided to physicians.

A proposed marketing program involving the use of physician practices and health care clinics to distribute coupons redeemable by certain retailers (including grocery stores, pharmacies, and internet companies) for discounts on items or services that are not reimbursable by any Federal health care program.

Concerning a corporate sponsorship program between Drug Company A ("Company A") and Charity B ("Charity B") (the "Proposed Arrangement").

Concerning an arrangement sponsored by Coalition A (the "Coalition") to provide psychotherapy services at free or reduced prices using residents from local teaching facilities as clinicians (the "Arrangement").

A proposed contractual arrangement between a self-insured employer health plan and a single-specialty managed care organization to provide managed podiatry benefits for the employer's retirees.

Whether an arrangement to provide for personal appearances by podiatrists to certain retail stores constitutes grounds for sanctions under the anti-kickback statute.

Whether an across-the-board waiver of any out-of-pocket beneficiary copayments for medical services covered by the national Eye Care Project constitutes grounds for the imposition of a sanction under section 1128A(a)(5) of the Act.

Whether the longstanding policy of a hospital, specializing in pediatric oncology research, of not billing its patients for any amounts associated with their treatment, including copayment amounts.

Whether a proposed agreement (the "Proposed Agreement"), pursuant to which Hospital District No.1 ("District One" or the "Requestor") would locate a medical clinic within the geographic boundaries of Hospital District No. 2 ("District Two"), would constitute grounds for sanctions under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act"), the exclusion authority for kickbacks.

Whether an annual fee imposed by city ordinance on ambulance companies wishing to provide ambulance services in the city (the "Ambulance Fee") constitutes prohibited remuneration under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act"), and, if so, whether the Ambulance Fee assessment constitutes grounds for the imposition of sanctions.

Whether a proposed pricing arrangement for a package of therapeutic mattresses for SNF patients to be marketed by a company, and certain commissioned agents, would result in prohibited remuneration under the anti-kickback statute.

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.

Whether the Arrangement constitutes prohibited remuneration within the meaning of the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act").

Whether an arrangement whereby an independent physician association would acquire an equity interest in a managed care organization would constitute grounds for the imposition of sanctions under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act"), the exclusion authority for kickbacks.

Whether an ophthalmologist's proposed sublease to an optometrist of certain imaging equipment (the "Sublease") would meet the criteria of the equipment rental safe harbor, 42 C.F.R. § 1001.952(c).