Browse Advisory Opinions

Certain pharmaceutical discount pricing arrangements that are limited to arrangements between a manufacturer and wholesalers (the "Proposed Arrangement") will subject you to sanction under the anti-kickback statute.

Whether a contractual arrangement for distribution and billing services between Company A and Company B (the ""Arrangement"") constitutes grounds for sanction under the anti-kickback statute.

Asks whether a proposed arrangement for restocking ambulance supplies and medications (the "Proposed Arrangement") would constitute illegal remuneration as defined in the anti-kickback statute, 42 U.S.C. § 1320a-7b(b).

Asks whether an outpatient radiology imaging center joint venture owned by a medical group specializing in radiology and a hospital care provider (i) generates prohibited remuneration within the meaning of the anti-kickback statute, Section 1128B of the Social Security Act ("Act"); (ii) constitutes grounds for the imposition of an exclusion under Section 1128(b)(7) of the Act (as it applies to kickbacks); (iii) constitutes grounds for criminal sanctions under Section 1128B(b) of the Act; and/or (iv) satisfies the criteria set out in Section 1128B(b)(3) of the Act or associated regulations, 42 C.F.R. § 1001.952.

Asks whether declining to pursue collection of copayments from certain patients who have employer-sponsored Medicare complementary coverage constitutes grounds for imposition of sanctions under Section 231(h) of the Health Insurance Portability and Accountability Act ("HIPAA") [42 U.S.C. § 1320a-7a(a)(5)] or under Sections 1128B(b) (the anti-kickback statute) or 1128A(7) (relating to payment of kickbacks) of the Social Security Act [42 U.S.C. §§ 1320a-7b(b) and 1320a-7(b)(7)].

Asks whether Mrs. P's transfer of assets to her nephew, Mr. S, and subsequent application for Medicaid benefits, subjects her to sanction under 42 U.S.C. § 1320a-7b(a)(6), which prohibits certain dispositions of assets for the purpose of qualifying for Medicaid.

Asks whether a state-funded program that pays for insurance premiums for financially needy Medicare beneficiaries with end-stage renal disease would constitute grounds for the imposition of a civil monetary penalty under Section 231(h) of the Health Insurance Portability and Accountability Act of 1996.

It is permissible for a charitable organization partly funded by kidney dialysis providers to pay Medicare Part B, Medigap and other health insurance premiums for end-stage renal disease patients who are financially needy.