Browse Advisory Opinions

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).

Whether donations by Company X ("Company X") to Organization A ("Organization A") (an independent, 501(c)(3) charitable organization) for the purpose of funding a program to pay for Supplementary Medical Insurance ("Medicare Part B") or Medicare Supplementary Health Insurance ("Medigap") premiums for financially needy Medicare beneficiaries with end-stage renal disease.

Whether an arrangement for contracted pharmacy services between University A and Pharmacy Company B to facilitate an outpatient pharmacy program for the University's hemophilia center pursuant to section 340B of the Public Health Service Act (the "Proposed Arrangement") would constitute grounds for sanctions under the anti-kickback statute.

Whether a proposed arrangement under which [Name redacted] would assign an employee pharmacist to work in designated hospital transplant centers for the purpose of providing pharmacy-related products and services (the "Proposed Arrangement") would constitute prohibited remuneration under the anti-kickback statute.

Whether an ambulance restocking program, coordinated through a local emergency medical services council (the "Program"), constitutes prohibited remuneration under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act"), and, if so, whether the Program constitutes grounds for the imposition of sanctions under the anti-kickback statute.

Whether an existing pharmaceutical restocking program (the "Drug Program") and a proposed medical supplies restocking program (the "Supply Program) (collectively, the "Arrangements") constitute prohibited remuneration under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act").

Whether a proposed joint venture among several orthopedic surgeons and anesthesiologists specializing in pain management to establish an ambulatory surgical center, as described in your request letter and supplemental submissions (the "Proposed Arrangement"), would generate prohibited remuneration.

Whether a proposed purchasing arrangement involving a trade association, its nursing home members, and an electrical utility consultant (the "Proposed Arrangement") constitutes prohibited remuneration under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act").

whether the payment of a sales commission to an independent manufacturers' representative (the "Arrangement") constitutes grounds for sanctions under the anti-kickback statute, section 1128B(b) of the Social Security Act (the "Act").