| On-call ED services required by EMTALA have become an increasingly divisive issue among physicians, physician leaders and hospitals. Given EMTALA's ultimate penalty on hospitals – termination from Medicare – no hospital can afford to violate the Act. EMTALA investigations and correcting violations are both demanding and exhausting.
Some hospitals have attempted to achieve on-call compliance by paying physician specialists to take call. Those payments come in many forms: beeper pay, response pay, a daily rate, guaranteed reimbursement and deferred compensation, to name just a few.
Other hospitals have chosen not to pay because they consider on-call service a responsibility of medical staff appointment or because they simply can't afford it. Some hospitals are still weighing their options.
Now, for the first time in writing, the Office of Inspector General has weighed in on whether payment for on-call services implicates the Antikickback Statute. In an Advisory Opinion posted on September 27, 2007, the OIG described a payment-for-call arrangement that it concluded presented a low risk of fraud and abuse, and for which the OIG will not impose administrative sanctions.
What does this mean for hospitals that have entered into different on-call payment arrangements? For those that may be considering payment for call?
Please join Henry Casale, Alan Steinberg and Ian Donaldson of Horty, Springer & Mattern as they describe and analyze the Advisory Opinion and discuss:
- Is the OIG Advisory Opinion a good outcome? A bad one? What does it mean for hospitals? For on-call specialists?
- Is an independent, third-party evaluation of the fair market value of on-call payments now required?
- To what extent must a hospital be able to document its difficulty in procuring ED on-call care?
- What if a hospital offers the same daily rate to all physicians seeking to provide ED on-call coverage regardless of specialty? Is it advisable to establish differing fair market value payments for different specialties?
- How closely must a payment arrangement follow the one described in the Advisory Opinion in order to be compliant with the AntiKickback Statute?
- The OIG can pursue civil and criminal penalties under the Antikickback Statute for a noncompliant call payment arrangement. The OIG can also fine hospitals and physicians under EMTALA for noncompliance, including on-call noncompliance. Within the OIG, are these two "camps" working together?
- Given the Advisory Opinion, what steps should hospitals and leadership take going forward?
Registration materials include the Advisory Opinion and an analysis and explanation of the Advisory Opinion written by the attorneys at Horty, Springer & Mattern. |
