IG: Residents' doctors may be hired as consultants
Corporations can legally hire former physicians of nursing home patients as on-call consultants, according to the Department of Health and Human Services' Office of the Inspector General. The physicians group questioning the IG was concerned about being charged with getting kick-backs under Medicare.
Because the professional group would compensate the consulting physician under a contract, and no federal healthcare program, patient or third party would be billed, the IG determined that this would not constitute the illegal payments detailed in Section 1128B(b) of the Medicare Act.
Consulting doctors would be the most useful source for determining a patient's history, such as past treatments, tests, and responses or reactions to medications, according to the physicians group.
The consulting physician would receive $50 per hour for a maximum number of hours per month, with a monthly maximum of $750 for 15 hours provided to 20 or more patients, the corporation said.
The IG said, however, that similar arrangements with independent contractor physicians, or similar payment arrangements with nursing homes, would raise fraud and abuse concerns.
The Inspector General's decision, which was issued Thursday, can be seen at www.oig.hhs.gov/fraud/docs/advisoryopinions/2004/ao0409.pdf.