Is Your Partner Excluded? Doctors, Take Note.

Posted by Frank Strafford on July 13, 2015 in Healthcare HR, Industry News,

 

An attorney with HHS’ Office of Inspector General said Thursday that the OIG is hiring additional lawyers to look into taking more administrative actions against doctors. They’re looking for the types of questionable payment arrangements addressed in an OIG fraud alert issued earlier this week.

Is Your Partner Excluded? Doctors, Take Note.

So begins Modern Healthcare’s expose on the OIG’s newly-awakened interest in pursuing allegations against individual doctors.

A number of legal experts agree that the alert, issued Tuesday, could signal that the feds plan to increasingly pursue allegations against individual doctors, rather than just the organizations that pay them. “The OIG’s going to start focusing on physicians,” said Adrienne Dresevic, an attorney with The Health Law Partners, at the conference. “This OIG alert is basically (directed at) the physician community.”

Will this alert, issued after a host of OIG settlements connected to the anti-kickback statute, extend to exclusion screening as well?

In all candor, exclusion screening as a compliance necessity is still coming of age.  The sheer confusion inherent in the legislature – Do we really need to screen against every state OIG?  Do we really need to screen every month?  Do we really need to screen every employee and vendor? – leaves the door wide open for gaps in exclusion screening protocols, even amongst big-time medical facilities and employers.  Add the fact that it seems far more logical for the OIG to target facilities, and it’s no wonder that small, privately-owned medical practices rarely bother with exclusion screening.

On the other hand…  Last month, Dr. Arastoo Yazdani, MD of Maryland paid $42,334.50 for inadvertently employing an excluded individual.  The settlement was a rarity, in a province that has been dominated by fines issued to facilities up until this point.  Dr. Yazdani self-disclosed, so there’s no proof that the OIG would have independently pursued a claim against him.  But if the anti-kickback fraud alert is truly an indication of the OIG’s intended focus for the future, you can’t help but wonder…

About Frank Strafford

About Frank Strafford

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