In OIG Advisory Opinion No.12-10, the OIG approved a radiology provider’s provision of free pre-authorization services to referring sources. The provision of free or discounted services to referral sources implicates the Federal Anti-Kickback Statute (if Medicare/Medicaid patients are involved) or the NJ/NY Anti-Kickback Statute (if private insurance/self-pay patients are involved). In this case, according to the OIG, there were several mitigating factors – safeguards – that reduced the risk of violation of the Federal Anti-Kickback Statute, including, without limitation, the fact that the free pre-authorization services would be offered to all referral sources of the radiology provider, and not just to certain providers. Absent these safeguards, the OIG likely would not have approved the arrangement. Thus, it is imperative that a provider implement all available safeguards to reduce the risk of violating the Federal Ant-Kickback Statute.
If you would like more information on how to develop a program for the provision of free pre-authorization services, contact Frier Levitt.
